Healthcare Provider Details

I. General information

NPI: 1437651643
Provider Name (Legal Business Name): ERIC GAYLE JONES LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2018
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4803 BOARDWALK DR STE 120
FORT COLLINS CO
80525-3798
US

IV. Provider business mailing address

4803 BOARDWALK DR STE 120
FORT COLLINS CO
80525-3798
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-3406
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09926122
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: