Provider Demographics
NPI:1538883616
Name:JONES, JALISA ARIELLE (LPC)
Entity type:Individual
Prefix:
First Name:JALISA
Middle Name:ARIELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 MCDONALD RD
Mailing Address - Street 2:N/A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222
Mailing Address - Country:US
Mailing Address - Phone:804-658-7696
Mailing Address - Fax:
Practice Address - Street 1:1953 MCDONALD RD
Practice Address - Street 2:N/A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222
Practice Address - Country:US
Practice Address - Phone:804-658-7696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011836101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty