Provider Demographics
NPI:1760931703
Name:JONES, STEPHANIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
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 1:3601 SW 29TH ST
Mailing Address - Street 2:#134
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2078
Mailing Address - Country:US
Mailing Address - Phone:513-502-6215
Mailing Address - Fax:
Practice Address - Street 1:3601 SW 29TH ST
Practice Address - Street 2:#134
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2078
Practice Address - Country:US
Practice Address - Phone:513-502-6215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2452103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical