Healthcare Provider Details

I. General information

NPI: 1487139267
Provider Name (Legal Business Name): CASSANDRA JONES LPCC, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 SHARKEY RD
MOREHEAD KY
40351-9719
US

IV. Provider business mailing address

420 SHARKEY RD
MOREHEAD KY
40351-9719
US

V. Phone/Fax

Practice location:
  • Phone: 606-356-6018
  • Fax:
Mailing address:
  • Phone: 606-356-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number268933
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number262442
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: