Provider Demographics
NPI:1437378817
Name:JONES, THEODORE (LPCMH, LCDP, CADC)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LPCMH, LCDP, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 SILVERSIDE ROAD
Mailing Address - Street 2:RIDGELY BLDG, STE 101B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-598-3831
Mailing Address - Fax:
Practice Address - Street 1:3519 SILVERSIDE RD
Practice Address - Street 2:RIDGELY BLDG, STE 101B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4909
Practice Address - Country:US
Practice Address - Phone:302-598-3831
Practice Address - Fax:302-691-3660
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELCDP #12101YA0400X
DELPCMH #287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)