Provider Demographics
NPI:1942663679
Name:JONES, ALEXANDRA (MA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-5518
Mailing Address - Country:US
Mailing Address - Phone:904-352-3224
Mailing Address - Fax:
Practice Address - Street 1:580 ELLIS RD S
Practice Address - Street 2:STE 118
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32254-3582
Practice Address - Country:US
Practice Address - Phone:904-423-0017
Practice Address - Fax:904-683-8169
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1942663679101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health