Provider Demographics
NPI:1346995453
Name:JONES, CATHY MAE (CSC-AD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:MAE
Last Name:JONES
Suffix:
Gender:F
Credentials:CSC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4920 NIAGARA RD STE 107
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1121
Mailing Address - Country:US
Mailing Address - Phone:301-446-3070
Mailing Address - Fax:301-446-3071
Practice Address - Street 1:4920 NIAGARA RD STE 107
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1121
Practice Address - Country:US
Practice Address - Phone:301-446-3070
Practice Address - Fax:301-446-3071
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC0379101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)