Provider Demographics
NPI:1265905517
Name:JONES, WILLIAM ALEXANDER JR
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ALEXANDER
Last Name:JONES
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1749GRAND CONCOURSE
Mailing Address - Street 2:1749 GRAND CONCOURSE APT PH8
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453
Mailing Address - Country:US
Mailing Address - Phone:917-982-0026
Mailing Address - Fax:
Practice Address - Street 1:1749GRAND CONCOURSE
Practice Address - Street 2:1749 GRAND CONCOURSE APT PH8
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453
Practice Address - Country:US
Practice Address - Phone:917-982-0026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician