Provider Demographics
NPI:1114645389
Name:JONES, MARIE (MHC-LP, MA)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MHC-LP, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E 94TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2905
Mailing Address - Country:US
Mailing Address - Phone:205-243-0204
Mailing Address - Fax:
Practice Address - Street 1:175 E 94TH ST APT 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2905
Practice Address - Country:US
Practice Address - Phone:917-674-3421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health