Healthcare Provider Details

I. General information

NPI: 1326634833
Provider Name (Legal Business Name): CORRI JONES LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9382 OAK AVE
WACONIA MN
55387-9422
US

IV. Provider business mailing address

9382 OAK AVE
WACONIA MN
55387-9422
US

V. Phone/Fax

Practice location:
  • Phone: 855-454-2463
  • Fax:
Mailing address:
  • Phone: 855-454-2463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5380
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: