Provider Demographics
NPI:1821581307
Name:JONES, JOSEPH III
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:JONES
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10732 S MALL DR APT 722
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-4819
Mailing Address - Country:US
Mailing Address - Phone:281-780-5274
Mailing Address - Fax:
Practice Address - Street 1:10732 S MALL DR APT 722
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-4819
Practice Address - Country:US
Practice Address - Phone:281-780-5274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX$$$$$$$$$Medicaid