Provider Demographics
NPI:1407625551
Name:JONES, KIMBERLY Y
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:Y
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 1ST AVE APT A224
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-9310
Mailing Address - Country:US
Mailing Address - Phone:717-315-3196
Mailing Address - Fax:
Practice Address - Street 1:3201 1ST AVE APT A224
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-9310
Practice Address - Country:US
Practice Address - Phone:717-315-3196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health