Provider Demographics
NPI:1477267235
Name:JONES, LESSIE D III
Entity Type:Individual
Prefix:MR
First Name:LESSIE
Middle Name:D
Last Name:JONES
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ARARAT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-3328
Mailing Address - Country:US
Mailing Address - Phone:508-341-2829
Mailing Address - Fax:
Practice Address - Street 1:154 INTERVALE RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-5951
Practice Address - Country:US
Practice Address - Phone:508-933-6085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician