Provider Demographics
NPI:1982680856
Name:JONES, CHAD ERIC (MS)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:ERIC
Last Name:JONES
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WILLOW LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LINDSBORG
Mailing Address - State:KS
Mailing Address - Zip Code:67456-5159
Mailing Address - Country:US
Mailing Address - Phone:785-577-0748
Mailing Address - Fax:
Practice Address - Street 1:16 WILLOW LAKE DR
Practice Address - Street 2:
Practice Address - City:LINDSBORG
Practice Address - State:KS
Practice Address - Zip Code:67456-5159
Practice Address - Country:US
Practice Address - Phone:785-577-0748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2435101YM0800X
MO2010012499101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional