Provider Demographics
NPI:1417006248
Name:JONES, NORMAN G (MED LSPE)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:G
Last Name:JONES
Suffix:
Gender:M
Credentials:MED LSPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072
Mailing Address - Country:US
Mailing Address - Phone:615-859-0191
Mailing Address - Fax:615-859-4990
Practice Address - Street 1:420 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072
Practice Address - Country:US
Practice Address - Phone:615-859-0191
Practice Address - Fax:615-859-9336
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1059101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health