Provider Demographics
NPI:1972378883
Name:JONES, AUSTIN (LPES, NCSP, SSP)
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LPES, NCSP, SSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 PISGAH RD # 18
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6705
Mailing Address - Country:US
Mailing Address - Phone:843-284-3038
Mailing Address - Fax:
Practice Address - Street 1:1951 PISGAH RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6705
Practice Address - Country:US
Practice Address - Phone:843-283-3038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4757103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool