Provider Demographics
NPI:1821593609
Name:JONES, GREGORY JOE
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:JOE
Last Name:JONES
Suffix:
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 1:11101 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1813
Mailing Address - Country:US
Mailing Address - Phone:216-721-3030
Mailing Address - Fax:216-721-0105
Practice Address - Street 1:11101 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1813
Practice Address - Country:US
Practice Address - Phone:216-721-3030
Practice Address - Fax:216-721-0105
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health