Provider Demographics
NPI:1275239253
Name:PHILLIPS, JONAH A (QMHS)
Entity Type:Individual
Prefix:
First Name:JONAH
Middle Name:A
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0188
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-773-4622
Practice Address - Street 1:8323 SR 7 N.
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:OH
Practice Address - Zip Code:45620-9001
Practice Address - Country:US
Practice Address - Phone:740-428-5012
Practice Address - Fax:740-428-5015
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator