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General NPI Number Information
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NPI Number | 1538637632
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Entity Type | Individual
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Provider Name | VALENCIA ANNAZETTE JONES LPC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 520 OLIVE ST STE 203
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City | SHREVEPORT
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State | LA
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Zip | 71104-2312
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Country | US
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Telephone | 318-200-0341
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Fax |
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Provider Business Mailing Address
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Address Line | 228 WASHINGTON
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City | SHREVEPORT
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State | LA
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Zip | 71104-2210
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Country | US
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Telephone | 318-272-9727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 171M00000X
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License Number State | LA
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