Provider Demographics
NPI:1093101321
Name:CRONE, JAMAAL (MAR, MED)
Entity Type:Individual
Prefix:
First Name:JAMAAL
Middle Name:
Last Name:CRONE
Suffix:
Gender:M
Credentials:MAR, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 S VEITCH ST
Mailing Address - Street 2:UNIT 407
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-3052
Mailing Address - Country:US
Mailing Address - Phone:703-300-0526
Mailing Address - Fax:
Practice Address - Street 1:2720 S VEITCH ST
Practice Address - Street 2:UNIT 407
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-3052
Practice Address - Country:US
Practice Address - Phone:703-300-0526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program