Provider Demographics
NPI:1235959032
Name:JONES, REGINALD ARNOLD (LPC)
Entity type:Individual
Prefix:
First Name:REGINALD
Middle Name:ARNOLD
Last Name:JONES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5595 MILLS RIDGE DR SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49418-8393
Mailing Address - Country:US
Mailing Address - Phone:616-617-8711
Mailing Address - Fax:
Practice Address - Street 1:5595 MILLS RIDGE DR SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49418-8393
Practice Address - Country:US
Practice Address - Phone:616-617-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty