Provider Demographics
NPI:1881126001
Name:JONES, WILLIAM KEITH (LPCC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:KEITH
Last Name:JONES
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:MR
Other - First Name:KEITH
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC
Mailing Address - Street 1:2812 SAGAMORE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-4010
Mailing Address - Country:US
Mailing Address - Phone:419-442-1199
Mailing Address - Fax:
Practice Address - Street 1:2812 SAGAMORE RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-4010
Practice Address - Country:US
Practice Address - Phone:419-442-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2102145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0279706Medicaid