Healthcare Provider Details

I. General information

NPI: 1669910998
Provider Name (Legal Business Name): CASSANDRA JONES LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S SPRING ST
TUPELO MS
38804-4822
US

IV. Provider business mailing address

PO BOX 68
TUPELO MS
38802-0068
US

V. Phone/Fax

Practice location:
  • Phone: 662-584-5097
  • Fax:
Mailing address:
  • Phone: 662-584-5097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8732
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1713
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: