Provider Demographics
NPI:1780788422
Name:JONES, JULIE KARENA (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:KARENA
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79A NORWICH AVENUE
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415
Mailing Address - Country:US
Mailing Address - Phone:860-930-3598
Mailing Address - Fax:860-537-6896
Practice Address - Street 1:79A NORWICH AVENUE
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415
Practice Address - Country:US
Practice Address - Phone:860-930-3598
Practice Address - Fax:860-537-6896
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001158101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0007190248OtherAETNA BEH. HEALTH PIN
CT240001158CT07OtherANTHEM BC/BS PIN
CT2078261OtherCIGNA PIN