Provider Demographics
NPI:1154511665
Name:JONES, JILL LYNN (MED)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 STRAITS RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03256-4714
Mailing Address - Country:US
Mailing Address - Phone:603-224-8996
Mailing Address - Fax:
Practice Address - Street 1:153 STRAITS RD
Practice Address - Street 2:
Practice Address - City:NEW HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03256-4714
Practice Address - Country:US
Practice Address - Phone:603-224-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH44101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ30009760Medicaid
NH1000845OtherANTHEM BLUE CROSS