Provider Demographics
NPI:1184111619
Name:JONES, CLANCY DEE (MD)
Entity type:Individual
Prefix:
First Name:CLANCY
Middle Name:DEE
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 BELMONT ST NW APT 107
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-6634
Mailing Address - Country:US
Mailing Address - Phone:479-684-1650
Mailing Address - Fax:
Practice Address - Street 1:1 PARK AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5802
Practice Address - Country:US
Practice Address - Phone:212-263-7419
Practice Address - Fax:212-263-7460
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3023912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry