Healthcare Provider Details

I. General information

NPI: 1548643901
Provider Name (Legal Business Name): KIERSTEN MARIE JONES MS, LCAS, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIERSTEN MARIE JONES MS, LCAS, LPCA

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 DEER HAVEN DR
RICHLANDS NC
28574-8406
US

IV. Provider business mailing address

216 DEER HAVEN DR
RICHLANDS NC
28574-8406
US

V. Phone/Fax

Practice location:
  • Phone: 252-315-9772
  • Fax:
Mailing address:
  • Phone: 252-315-9772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12820
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-21653
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA12820
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: