Provider Demographics
NPI:1417367160
Name:JONES, MIKA (PHD)
Entity Type:Individual
Prefix:
First Name:MIKA
Middle Name:
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 1:250 COMMERCIAL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1726
Mailing Address - Country:US
Mailing Address - Phone:508-752-4665
Mailing Address - Fax:
Practice Address - Street 1:69 COREY HILL RD
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430-1263
Practice Address - Country:US
Practice Address - Phone:508-360-3238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-03
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health