Provider Demographics
NPI:1528443678
Name:JONES, LACHELLE RICHARDSON (LCSW)
Entity type:Individual
Prefix:
First Name:LACHELLE
Middle Name:RICHARDSON
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 E 250 N
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2906
Mailing Address - Country:US
Mailing Address - Phone:801-624-9824
Mailing Address - Fax:
Practice Address - Street 1:1290 S 500 W STE 300
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8104
Practice Address - Country:US
Practice Address - Phone:385-461-2971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
UT1129384335021041C0700X
UT11293843-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor