Provider Demographics
NPI:1326089467
Name:JONES, MARK P (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:JONES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ROBERT TONER BLVD
Mailing Address - Street 2:STE. 5, #222
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02763-1174
Mailing Address - Country:US
Mailing Address - Phone:508-954-2355
Mailing Address - Fax:508-384-1818
Practice Address - Street 1:100 COPELAND DR
Practice Address - Street 2:SUITE 7
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1245
Practice Address - Country:US
Practice Address - Phone:508-954-2355
Practice Address - Fax:508-384-1818
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7630103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA251642000OtherMAGELLAN
MAW05956OtherBCBSMA
MA1890701Medicaid
MAW51221Medicare ID - Type UnspecifiedMEDICARE PART B