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JEAN S CARON ADTR, LISAC, LPC

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1184753378

Individual Registrant:
 JEAN S CARON ADTR, LISAC, LPC
Gender: F
Sole Proprietor

Location and contact information for practice:
5 WHITE MOUNTAIN AVENUE  SAN CARLOS, AZ 85550 US
Tel: 928-475-4875  Fax: --

Contact information for business:
365 S FIRST ST  GLOBE, AZ 85501-1801 US
Tel: 928-402-9347  Fax: --

Registration Information:
NPI: 1184753378
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
X101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
AZ11693
X101YP2500XBehavioral Health & Social Service Providers
Counselor
AZ106105

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
STATE MH LICENSE106105AZ01
STATE SUB ABUSE LICENSE11693AZ01




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