Provider Demographics
NPI:1235902552
Name:JONES, GREGORY LYNN
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 DERBY LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6324
Mailing Address - Country:US
Mailing Address - Phone:903-805-4233
Mailing Address - Fax:
Practice Address - Street 1:405 DERBY LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6324
Practice Address - Country:US
Practice Address - Phone:903-805-4233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker