Provider Demographics
NPI:1699109249
Name:JONES, KRISTINE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
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 1:6 DELLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1269
Mailing Address - Country:US
Mailing Address - Phone:314-249-5177
Mailing Address - Fax:417-944-1440
Practice Address - Street 1:1031 PERUQUE CROSSING CT
Practice Address - Street 2:
Practice Address - City:OFALLON
Practice Address - State:MO
Practice Address - Zip Code:63366
Practice Address - Country:US
Practice Address - Phone:314-249-5177
Practice Address - Fax:417-944-1440
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016013004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional