Provider Demographics
NPI:1326255977
Name:JONES, PAUL EDWARD (MA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:JONES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8106 EAGLES CREST CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-2290
Mailing Address - Country:US
Mailing Address - Phone:502-594-6587
Mailing Address - Fax:
Practice Address - Street 1:8106 EAGLES CREST CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-2290
Practice Address - Country:US
Practice Address - Phone:502-594-6587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0032106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist