Provider Demographics
NPI:1326291808
Name:JONES, JAMES L JR (CADC II)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:JONES
Suffix:JR
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5375 SUGARLOAF PKWY APT 13107
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7824
Mailing Address - Country:US
Mailing Address - Phone:810-875-4383
Mailing Address - Fax:
Practice Address - Street 1:3543 HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-4336
Practice Address - Country:US
Practice Address - Phone:678-615-2382
Practice Address - Fax:770-674-0250
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-04066101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI750910966OtherBCBS