Provider Demographics
NPI:1689837494
Name:JONES, JOAN WICKHAM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:WICKHAM
Last Name:JONES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W DAVIES AVE N
Mailing Address - Street 2:STE 105
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5211
Mailing Address - Country:US
Mailing Address - Phone:303-730-1717
Mailing Address - Fax:303-730-1531
Practice Address - Street 1:141 W DAVIES AVE N
Practice Address - Street 2:STE 105
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5211
Practice Address - Country:US
Practice Address - Phone:303-730-1717
Practice Address - Fax:303-730-1531
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3048103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO304411Medicare UPIN