Provider Demographics
NPI:1184975633
Name:JONES, MEREDITH KATHERINE (PHD)
Entity type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:KATHERINE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 COMMONWEALTH AVENUE
Mailing Address - Street 2:909
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2707
Mailing Address - Country:US
Mailing Address - Phone:404-693-5404
Mailing Address - Fax:
Practice Address - Street 1:29 COMMONWEALTH AVE
Practice Address - Street 2:909
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2349
Practice Address - Country:US
Practice Address - Phone:404-693-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9588103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical