Provider Demographics
NPI:1396814521
Name:JONES, GABRIELE DENISE (PHD)
Entity Type:Individual
Prefix:
First Name:GABRIELE
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 TROTTER HILLS CIR
Mailing Address - Street 2:PO BOX 4600
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-7930
Mailing Address - Country:US
Mailing Address - Phone:910-255-1000
Mailing Address - Fax:910-255-1045
Practice Address - Street 1:5 REGIONAL CIR STE C
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9796
Practice Address - Country:US
Practice Address - Phone:910-255-1000
Practice Address - Fax:910-255-1045
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2716103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC045VPOtherBCBS PIN
NC6000809Medicaid
NCQ41321B777OtherMEDICARE IND PTAN