Provider Demographics
NPI:1194281295
Name:JONES, JESSICA ANGEL (LCPC, LCADC)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANGEL
Last Name:JONES
Suffix:
Gender:F
Credentials:LCPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 GREEN ARBOUR CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2227
Mailing Address - Country:US
Mailing Address - Phone:240-412-7616
Mailing Address - Fax:
Practice Address - Street 1:2214 GREEN ARBOUR CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2227
Practice Address - Country:US
Practice Address - Phone:240-412-7616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9950101YP2500X
MDLCA2716101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)