Provider Demographics
NPI:1225067671
Name:JONES, SARAH W (PHD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:W
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HENDERSON MILL RD NE
Mailing Address - Street 2:STE.308
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2704
Mailing Address - Country:US
Mailing Address - Phone:770-938-0303
Mailing Address - Fax:770-939-3927
Practice Address - Street 1:2300 HENDERSON MILL RD NE
Practice Address - Street 2:STE.308
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2745
Practice Address - Country:US
Practice Address - Phone:770-938-0303
Practice Address - Fax:770-939-3927
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1733103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000706527BMedicaid
GA68BBGMRMedicare ID - Type UnspecifiedPROVIDER NUMBER