Healthcare Provider Details

I. General information

NPI: 1144615964
Provider Name (Legal Business Name): DRJONESPLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 U ST NW THIRD FLOOR
WASHINGTON DC
20009-7991
US

IV. Provider business mailing address

1330 U ST NW THIRD FLOOR
WASHINGTON DC
20009-7991
US

V. Phone/Fax

Practice location:
  • Phone: 202-888-5595
  • Fax:
Mailing address:
  • Phone: 202-888-5595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1000546
License Number StateDC

VIII. Authorized Official

Name: DR. GREGORY MICHAEL JONES
Title or Position: OWNER
Credential: PSY.D.
Phone: 202-888-5595