Provider Demographics
NPI:1518602440
Name:JONES, NOAH ALEXANDER
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:ALEXANDER
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 1:2162 H E JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-8449
Mailing Address - Country:US
Mailing Address - Phone:270-438-9783
Mailing Address - Fax:
Practice Address - Street 1:2162 H E JOHNSON RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-8449
Practice Address - Country:US
Practice Address - Phone:270-438-9783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health