Individual
JESSICA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAEDS NCC LPCA LCASA
Contact information
Practice address
636 SIGNAL HILL DRIVE EXT, STATESVILLE, NC 28625-4774
(704) 871-2992
(704) 871-2994
Mailing address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
(704) 332-9001
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-22033
NC
101YP2500X
Professional Counselor
A11894
NC
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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