Provider Demographics
NPI:1861883357
Name:JONES, KRISTEN SONGSTAD (DPC, LPC, NCC)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:SONGSTAD
Last Name:JONES
Suffix:
Gender:F
Credentials:DPC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 TRACEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211
Mailing Address - Country:US
Mailing Address - Phone:769-972-1986
Mailing Address - Fax:
Practice Address - Street 1:2085 MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-8520
Practice Address - Country:US
Practice Address - Phone:601-405-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1059921OtherBLUE CROSS BLUE SHIELD MISSISSIPPI