Healthcare Provider Details

I. General information

NPI: 1548915374
Provider Name (Legal Business Name): KRISTEN ELIZABETH JONES RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3721 6TH AVE S
BIRMINGHAM AL
35222-2409
US

IV. Provider business mailing address

1577 BEULAH CIR
SPRINGVILLE AL
35146-5004
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-1088
  • Fax:
Mailing address:
  • Phone: 205-307-8196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number20-53-49-217315
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: