Provider Demographics
NPI:1104943539
Name:JONES, LORI RATH (MA, CAS, LPA, HSP-PA)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:RATH
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, CAS, LPA, HSP-PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27828-9998
Mailing Address - Country:US
Mailing Address - Phone:252-531-6001
Mailing Address - Fax:
Practice Address - Street 1:223 COMMERCE ST STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5032
Practice Address - Country:US
Practice Address - Phone:252-531-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2446103T00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool