Provider Demographics
NPI:1508753716
Name:JONES, WILLIE
Entity type:Individual
Prefix:MR
First Name:WILLIE
Middle Name:
Last Name:JONES
Suffix:
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 1:4771 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-9631
Mailing Address - Country:US
Mailing Address - Phone:330-296-2384
Mailing Address - Fax:
Practice Address - Street 1:4771 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-9631
Practice Address - Country:US
Practice Address - Phone:330-296-2384
Practice Address - Fax:330-296-2466
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)