Provider Demographics
NPI:1548643901
Name:JONES, KIERSTEN MARIE (MS, LCAS, LCMHC)
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, LCAS, LCMHC
Other - Prefix:
Other - First Name:KIERSTEN
Other - Middle Name:MARIE
Other - Last Name:TALBOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LCAS, LPCA
Mailing Address - Street 1:1770 OLD WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:VANCEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28586-9010
Mailing Address - Country:US
Mailing Address - Phone:252-315-9772
Mailing Address - Fax:
Practice Address - Street 1:1770 OLD WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:VANCEBORO
Practice Address - State:NC
Practice Address - Zip Code:28586-9010
Practice Address - Country:US
Practice Address - Phone:252-315-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12820101YP2500X
NCA12820101YP2500X
NCLCAS-21653101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional