Provider Demographics
NPI:1528704954
Name:HORTON JONES, MARY KATHERINE (LPC, BC-TMH)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:HORTON JONES
Suffix:
Gender:F
Credentials:LPC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 E HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-3119
Mailing Address - Country:US
Mailing Address - Phone:662-392-1239
Mailing Address - Fax:
Practice Address - Street 1:400 HOWARD ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-4338
Practice Address - Country:US
Practice Address - Phone:662-392-1239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2612101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional