Provider Demographics
NPI:1730280397
Name:JONES, VERNARD R (LCMHT,CCAP,MAC,ICADC)
Entity Type:Individual
Prefix:MR
First Name:VERNARD
Middle Name:R
Last Name:JONES
Suffix:
Gender:M
Credentials:LCMHT,CCAP,MAC,ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-3639
Mailing Address - Country:US
Mailing Address - Phone:662-253-5085
Mailing Address - Fax:
Practice Address - Street 1:920 BOONE ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-5908
Practice Address - Country:US
Practice Address - Phone:662-844-3531
Practice Address - Fax:662-844-1757
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS00-0075101YA0400X
MSLH0602101YA0400X
MS502094101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)