Healthcare Provider Details
I. General information
NPI: 1699190306
Provider Name (Legal Business Name): JONES-WOOD PSYCHOLOGICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2014
Last Update Date: 11/18/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9826 WASHINGTON ST
CHAGRIN FALLS OH
44023-5486
US
IV. Provider business mailing address
9826 WASHINGTON ST
CHAGRIN FALLS OH
44023-5486
US
V. Phone/Fax
- Phone: 440-708-0188
- Fax: 440-708-0368
- Phone: 440-708-0188
- Fax: 440-708-0368
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LYNN
ANN
LUNA JONES
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 440-708-0188