Provider Demographics
NPI:1467543579
Name:JONES, DAVID (LPC, PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1963 W MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204-4217
Mailing Address - Country:US
Mailing Address - Phone:601-346-4479
Mailing Address - Fax:601-372-7361
Practice Address - Street 1:1963 W MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-4217
Practice Address - Country:US
Practice Address - Phone:601-346-4479
Practice Address - Fax:601-372-7361
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0096101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional