Provider Demographics
NPI:1457459240
Name:ADKINS, JONES M (PSYD LP)
Entity Type:Individual
Prefix:
First Name:JONES
Middle Name:M
Last Name:ADKINS
Suffix:
Gender:M
Credentials:PSYD LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 13TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2614
Mailing Address - Country:US
Mailing Address - Phone:320-252-5010
Mailing Address - Fax:320-203-1855
Practice Address - Street 1:730 DODGE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-2889
Practice Address - Country:US
Practice Address - Phone:763-441-3770
Practice Address - Fax:763-441-9057
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
6105544OtherUBH
0265047OtherPREFERRED ONE
HP22809OtherHEALTH PARTNERS
225K7ASOtherBCBS