Provider Demographics
NPI:1316267602
Name:JONES, JEMBRALYN (LPC)
Entity type:Individual
Prefix:
First Name:JEMBRALYN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-2519
Mailing Address - Country:US
Mailing Address - Phone:803-447-0001
Mailing Address - Fax:803-447-0001
Practice Address - Street 1:106 FABRISTER LN
Practice Address - Street 2:SUITE D
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-1911
Practice Address - Country:US
Practice Address - Phone:803-957-0794
Practice Address - Fax:866-576-2589
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional