Provider Demographics
NPI:1952505893
Name:JAMES A JONES JR
Entity Type:Organization
Organization Name:JAMES A JONES JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:731-664-1922
Mailing Address - Street 1:378 CARRIAGE HOUSE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2254
Mailing Address - Country:US
Mailing Address - Phone:731-664-1922
Mailing Address - Fax:731-661-0779
Practice Address - Street 1:378 CARRIAGE HOUSE DR
Practice Address - Street 2:SUITE F
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2254
Practice Address - Country:US
Practice Address - Phone:731-664-1922
Practice Address - Fax:731-661-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000000380251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3698696Medicaid
TN3698696Medicare ID - Type Unspecified