Provider Demographics
NPI:1457422958
Name:JONES, CYNTHIA ANTOINETTE (PH D)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANTOINETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CARDINAL PARK DR SE
Mailing Address - Street 2:SUITE 104A
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4448
Mailing Address - Country:US
Mailing Address - Phone:703-779-8700
Mailing Address - Fax:703-779-9767
Practice Address - Street 1:2 CARDINAL PARK DR SE
Practice Address - Street 2:SUITE 104A
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4448
Practice Address - Country:US
Practice Address - Phone:703-779-8700
Practice Address - Fax:703-779-9767
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001851103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA207999OtherANTHEM BC BS