Provider Demographics
NPI:1528556867
Name:JONES, TERESA (MA, CAP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, CAP
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:WOOTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CAP
Mailing Address - Street 1:3976 WOODVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-7449
Mailing Address - Country:US
Mailing Address - Phone:850-878-7776
Mailing Address - Fax:850-878-8086
Practice Address - Street 1:3976 WOODVILLE HWY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-7449
Practice Address - Country:US
Practice Address - Phone:850-878-7776
Practice Address - Fax:850-878-8086
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)