Provider Demographics
NPI:1376617316
Name:JONES, JAMES AUSBIN JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:AUSBIN
Last Name:JONES
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:378 CARRIAGE HOUSE DR STE F
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2254
Mailing Address - Country:US
Mailing Address - Phone:731-664-1922
Mailing Address - Fax:731-664-0779
Practice Address - Street 1:378 CARRIAGE HOUSE DR STE F
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2254
Practice Address - Country:US
Practice Address - Phone:731-664-1922
Practice Address - Fax:731-664-0779
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000003801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN36986951Medicaid
TN36986951Medicare PIN