Provider Demographics
NPI:1952827966
Name:JONES, JEREMY ALEXANDER (LCSWA)
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:ALEXANDER
Last Name:JONES
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 NC-54 SUITE C
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1936
Mailing Address - Country:US
Mailing Address - Phone:919-682-5300
Mailing Address - Fax:919-872-6223
Practice Address - Street 1:5809 DEPARTURE DR STE 106
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-1936
Practice Address - Country:US
Practice Address - Phone:919-872-6220
Practice Address - Fax:919-872-6223
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0157561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty