Provider Demographics
NPI:1922473156
Name:JONES, JAMES GREGORY
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GREGORY
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 1:839 BESTGATE RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3472
Mailing Address - Country:US
Mailing Address - Phone:410-222-6001
Mailing Address - Fax:410-222-2113
Practice Address - Street 1:839 BESTGATE RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:410-222-6001
Practice Address - Fax:410-222-2113
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2354101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)