Provider Demographics
NPI:1548682651
Name:JONES, AMY VAUN (LPC 1884)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:VAUN
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC 1884
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 17TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82201-2431
Mailing Address - Country:US
Mailing Address - Phone:307-331-2014
Mailing Address - Fax:307-322-2100
Practice Address - Street 1:602 9TH ST
Practice Address - Street 2:
Practice Address - City:WHEATLAND
Practice Address - State:WY
Practice Address - Zip Code:82201-2906
Practice Address - Country:US
Practice Address - Phone:307-331-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1047101Y00000X
WYLPC-1884101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health