Provider Demographics
NPI:1811751142
Name:JONES, DIANA L (MA)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 WHITTING DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-4704
Mailing Address - Country:US
Mailing Address - Phone:571-439-9046
Mailing Address - Fax:
Practice Address - Street 1:385 GARRISONVILLE RD STE 116
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-8900
Practice Address - Country:US
Practice Address - Phone:540-782-8878
Practice Address - Fax:866-463-1099
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013090101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional