Provider Demographics
NPI:1922024603
Name:JONES, DANIEL E (PHD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 MCCRACKEN RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2914
Mailing Address - Country:US
Mailing Address - Phone:216-587-8350
Mailing Address - Fax:216-587-8646
Practice Address - Street 1:12300 MCCRACKEN RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2914
Practice Address - Country:US
Practice Address - Phone:216-587-8350
Practice Address - Fax:216-587-8646
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3541103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000216092OtherANTHEM BLUE CROSS PIN
OHT03541OtherSUMMACARE HEALTH PLAN
OH740996OtherBUCKEYE HEALTH PLAN
OH0592890Medicaid
OH000000216092OtherUNICARE
OH351651OtherWELLCARE HEALTH PLAN
OH5497572OtherAETNA
OH0592890Medicaid
OHCP25452Medicare PIN