Healthcare Provider Details

I. General information

NPI: 1295656759
Provider Name (Legal Business Name): LYNA TEVENAZ JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N 200 W STE 2
ST GEORGE UT
84770-1303
US

IV. Provider business mailing address

55 N 200 W STE 2
ST GEORGE UT
84770-1303
US

V. Phone/Fax

Practice location:
  • Phone: 435-301-8969
  • Fax: 435-359-5016
Mailing address:
  • Phone: 435-301-8969
  • Fax: 435-359-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13961438-6009
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: