Provider Demographics
NPI:1538755020
Name:JONES, LAVITA DIANNE RINCHELLE (LCSW-S, CCTP II)
Entity type:Individual
Prefix:
First Name:LAVITA
Middle Name:DIANNE RINCHELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW-S, CCTP II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 S GOLIAD ST UNIT 301
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-1912
Mailing Address - Country:US
Mailing Address - Phone:469-338-2338
Mailing Address - Fax:855-795-1942
Practice Address - Street 1:609 S GOLIAD ST UNIT 301
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-1912
Practice Address - Country:US
Practice Address - Phone:469-338-2338
Practice Address - Fax:855-795-1942
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104242101YA0400X, 101YM0800X, 1041C0700X, 261QM0801X
TX24958101YM0800X, 261QM0801X, 261QM0855X, 1041C0700X, 101YA0400X, 261QR0405X
FLTPSW1951101YM0800X
FLTPSW15911041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder