Provider Demographics
NPI:1760098727
Name:JONES, ANNA MARIE (CDCA 1)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:CDCA 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PORTSMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-1622
Mailing Address - Country:US
Mailing Address - Phone:740-286-2918
Mailing Address - Fax:740-286-1374
Practice Address - Street 1:32 PORTSMOUTH ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-1622
Practice Address - Country:US
Practice Address - Phone:740-286-2918
Practice Address - Fax:740-286-1374
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174303101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)