Provider Demographics
NPI:1366742736
Name:JONES, KIM DENISE (LCP,C)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5634
Mailing Address - Country:US
Mailing Address - Phone:406-431-8833
Mailing Address - Fax:
Practice Address - Street 1:535 SADDLE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5634
Practice Address - Country:US
Practice Address - Phone:406-431-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1508101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health