Provider Demographics
NPI:1922762590
Name:JONES, TIMOTHY M (LMHC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 SINGLETON CIR
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-8312
Mailing Address - Country:US
Mailing Address - Phone:765-603-7015
Mailing Address - Fax:
Practice Address - Street 1:1102 SINGLETON CIR
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-8312
Practice Address - Country:US
Practice Address - Phone:765-603-7015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health