1457698466 NPI number — MS. ELISE C JONES MA, LPCI, LMHC

Table of content: MS. ELISE C JONES MA, LPCI, LMHC (NPI 1457698466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457698466 NPI number — MS. ELISE C JONES MA, LPCI, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
ELISE
Provider Middle Name:
C
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LPCI, LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457698466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4400 NE 77TH AVE
Provider Second Line Business Mailing Address:
SUITE 275
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98662-6829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-597-7200
Provider Business Mailing Address Fax Number:
360-713-6102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4400 NE 77TH AVE.,
Provider Second Line Business Practice Location Address:
SUITE 275
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-430-7262
Provider Business Practice Location Address Fax Number:
503-412-8226
Provider Enumeration Date:
01/10/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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