Provider Demographics
NPI:1740002245
Name:JONES, JAMES P (PHD, HSPP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IN
Mailing Address - Zip Code:46034-0184
Mailing Address - Country:US
Mailing Address - Phone:765-639-1707
Mailing Address - Fax:
Practice Address - Street 1:18025 RIVER RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8300
Practice Address - Country:US
Practice Address - Phone:765-639-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042820A103TH0100X
IN1595441103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service