Provider Demographics
NPI:1376948208
Name:JONES, AVON JR
Entity Type:Individual
Prefix:MR
First Name:AVON
Middle Name:
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 NORTH BROAD STREE
Mailing Address - Street 2:UNIT 4A
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709
Mailing Address - Country:US
Mailing Address - Phone:302-359-5510
Mailing Address - Fax:302-697-4029
Practice Address - Street 1:468 BROOKFIELD DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-6406
Practice Address - Country:US
Practice Address - Phone:302-359-5510
Practice Address - Fax:302-697-4029
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007600101YP2500X
DE0000703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional