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General NPI Number Information
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NPI Number | 1669906509
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Entity Type | Individual
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Provider Name | SUSAN JONES LPC
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Gender | Female
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 200 NW 4TH ST BLDG 600
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City | BRYANT
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State | AR
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Zip | 72022-3424
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Country | US
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Telephone | 501-653-5061
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Fax | 501-847-5662
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Provider Business Mailing Address
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Address Line | 200 NW 4TH ST BLDG 600
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City | BRYANT
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State | AR
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Zip | 72022-3424
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Country | US
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Telephone | 501-653-5061
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Fax | 501-847-5662
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P0311043
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License Number State | AR
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