Provider Demographics
NPI:1366630063
Name:JONES, MARK F (LMFT)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:F
Last Name:JONES
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11202 DISCO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2860
Mailing Address - Country:US
Mailing Address - Phone:210-495-2797
Mailing Address - Fax:210-499-4217
Practice Address - Street 1:11202 DISCO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2860
Practice Address - Country:US
Practice Address - Phone:210-495-2797
Practice Address - Fax:210-499-4217
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001986106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74-2609773Medicaid