Provider Demographics
NPI:1306947627
Name:KEETON, JONA M (LMFT, PMHCNS-BC)
Entity type:Individual
Prefix:MRS
First Name:JONA
Middle Name:M
Last Name:KEETON
Suffix:
Gender:F
Credentials:LMFT, PMHCNS-BC
Other - Prefix:MRS
Other - First Name:JONA
Other - Middle Name:
Other - Last Name:KEETON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PASTORAL COUNSELOR
Mailing Address - Street 1:361 TOWNE CENTER PL
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4869
Mailing Address - Country:US
Mailing Address - Phone:601-977-9353
Mailing Address - Fax:601-977-9422
Practice Address - Street 1:361 TOWNE CENTER PL
Practice Address - Street 2:SUITE 1300
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4869
Practice Address - Country:US
Practice Address - Phone:601-977-9353
Practice Address - Fax:601-977-9422
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0203106H00000X
MSR533084364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS20 520558LOtherTAX ID FOR A BRIDGE TO RECOVERY