Provider Demographics
NPI:1285725135
Name:JONES, RONALD RAY (LPC)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:RAY
Last Name:JONES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-2602
Mailing Address - Country:US
Mailing Address - Phone:208-670-0125
Mailing Address - Fax:
Practice Address - Street 1:1061 BLUE LAKES BLVD N
Practice Address - Street 2:SUITE 104
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3362
Practice Address - Country:US
Practice Address - Phone:208-734-0407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-3000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health