Provider Demographics
NPI:1932735495
Name:JONES, THOMAS W III (LAPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:W
Last Name:JONES
Suffix:III
Gender:M
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5182 AFTON WAY SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-2669
Mailing Address - Country:US
Mailing Address - Phone:678-523-0990
Mailing Address - Fax:
Practice Address - Street 1:5182 AFTON WAY SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-2669
Practice Address - Country:US
Practice Address - Phone:678-523-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006675101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAAPC006675OtherGEORGIA SECRETARY OF STATE - LAPC