Provider Demographics
NPI:1659084994
Name:JONES, JEREMY (LCADC, LPCA)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LCADC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 S 44TH ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-2721
Mailing Address - Country:US
Mailing Address - Phone:502-907-7541
Mailing Address - Fax:
Practice Address - Street 1:725 S 44TH ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40211-2721
Practice Address - Country:US
Practice Address - Phone:502-907-7541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)