Healthcare Provider Details

I. General information

NPI: 1932854619
Provider Name (Legal Business Name): KRISTIN JONES LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7741 MARKET ST STE A
WILMINGTON NC
28411-9444
US

IV. Provider business mailing address

7741 MARKET ST STE A
WILMINGTON NC
28411-9444
US

V. Phone/Fax

Practice location:
  • Phone: 910-338-9511
  • Fax:
Mailing address:
  • Phone: 910-338-9511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: KRISTIN JONES
Title or Position: OWNER
Credential: LCSW
Phone: 910-338-9511