Provider Demographics
NPI:1336273952
Name:JONES, CONNIE RENEE (MS, LIMHP)
Entity type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:MS, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 S 42ND ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-2942
Mailing Address - Country:US
Mailing Address - Phone:402-210-7123
Mailing Address - Fax:402-401-6798
Practice Address - Street 1:4239 FARNAM SUITE 710
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2942
Practice Address - Country:US
Practice Address - Phone:402-552-6007
Practice Address - Fax:402-552-3819
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7146101YM0800X
NE1589101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025022200Medicaid