Provider Demographics
NPI:1588713614
Name:JONES, DANIELLE G (M COUN, LPC)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:G
Last Name:JONES
Suffix:
Gender:F
Credentials:M COUN, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3683 N ARBORCREST CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1981
Mailing Address - Country:US
Mailing Address - Phone:208-887-9376
Mailing Address - Fax:
Practice Address - Street 1:4822 N ROSEPOINT WAY
Practice Address - Street 2:SUITE A
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-0944
Practice Address - Country:US
Practice Address - Phone:208-939-6110
Practice Address - Fax:208-939-6274
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-3606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLPC-3606OtherLICENSED PROF COUNSELOR