Healthcare Provider Details

I. General information

NPI: 1811502305
Provider Name (Legal Business Name): GAYE L JONES-WASHINGTON LPC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 10/28/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18411 FAWN TREE DR
LITTLE ROCK AR
72210-7131
US

IV. Provider business mailing address

18411 FAWN TREE DR
LITTLE ROCK AR
72210-7131
US

V. Phone/Fax

Practice location:
  • Phone: 501-258-2040
  • Fax:
Mailing address:
  • Phone: 501-313-0825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP2109003
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License NumberP2109003
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP2109003
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: