Provider Demographics
NPI:1861252645
Name:JONES, JARVIS (LPC)
Entity type:Individual
Prefix:
First Name:JARVIS
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:JARVIS
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 E LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3407
Mailing Address - Country:US
Mailing Address - Phone:601-502-6138
Mailing Address - Fax:
Practice Address - Street 1:517 KEYWOOD CIR STE 2B
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-3054
Practice Address - Country:US
Practice Address - Phone:601-559-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional