Provider Demographics
NPI:1073209839
Name:JONES, MONIQUE (QBHS)
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:QBHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 S JAMES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1696
Mailing Address - Country:US
Mailing Address - Phone:765-437-6431
Mailing Address - Fax:
Practice Address - Street 1:40 S JAMES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1696
Practice Address - Country:US
Practice Address - Phone:614-416-0294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 261QC1500X
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health