VICKI A JONES LAC
Addiction Substance Use Disorder
Minot, North Dakota
Provider NPI: 1679504575
Provider Information:VICKI A JONES LAC
Gender: F
Sole Proprietor
Practice Location:
1809 S BROADWAY STE S MINOT, ND 58701 US
Tel: 701-240-3775 Fax: --
Business Mailing Address:
1809 S BROADWAY STE S MINOT, ND 58701 US
Tel: 701-240-3775 Fax: --
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | ND | 1493 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
054517 | ND | 05 | |
BCBS ND PIN | 022792 | ND | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin