Provider Demographics
NPI:1376524082
Name:JONES, BEN MORGAN (PHD)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:MORGAN
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-1914
Mailing Address - Country:US
Mailing Address - Phone:814-946-1423
Mailing Address - Fax:814-946-1423
Practice Address - Street 1:2633 BROAD AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-1914
Practice Address - Country:US
Practice Address - Phone:814-946-1423
Practice Address - Fax:814-946-1423
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004444L103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109556OtherTRICARE
PA2015094OtherCIGNA
PA119532OtherHIGHMARK
PAFOCUSOther740812
PA109556OtherVALUE OPTIONS
PA0004347392OtherAETNA
PA232147OtherMHN
PA849747OtherFIRST HEALTH
PA849747OtherAFFORDABLE
PAPA20266OtherADVANTAGE HEALTH
PAVI7661OtherEMPIRE BLUE
PA0012221930001Medicaid
PAP00022445OtherRR MEDICARE
PAA19532OtherICHP
PA232147OtherMHN
PA109556OtherTRICARE