Provider Demographics
NPI:1982764445
Name:JONES, EDWARD ANTHONY (EDD, CCMHC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ANTHONY
Last Name:JONES
Suffix:
Gender:M
Credentials:EDD, CCMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 KENTUCKY DAM RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-9339
Mailing Address - Country:US
Mailing Address - Phone:270-444-0411
Mailing Address - Fax:888-298-7296
Practice Address - Street 1:100 FOUNTAIN AVE
Practice Address - Street 2:CENTURY BUILDING -- SUITE 105
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-2771
Practice Address - Country:US
Practice Address - Phone:270-444-0411
Practice Address - Fax:888-298-7296
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 0202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist