Provider Demographics
NPI:1962280776
Name:JONES, JESSICA NOELLE (LRIC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:NOELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:LRIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17333 PICKWICK DR
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-6173
Mailing Address - Country:US
Mailing Address - Phone:571-364-0757
Mailing Address - Fax:
Practice Address - Street 1:17333 PICKWICK DR
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-6173
Practice Address - Country:US
Practice Address - Phone:571-577-3240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health