Healthcare Provider Details

I. General information

NPI: 1063080471
Provider Name (Legal Business Name): MR. BRIAN ANTHONY JONES SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2021
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 W CHESTER PIKE STE C2
WEST CHESTER PA
19382-7782
US

IV. Provider business mailing address

1515 W CHESTER PIKE STE C2
WEST CHESTER PA
19382-7782
US

V. Phone/Fax

Practice location:
  • Phone: 267-277-3707
  • Fax: 267-382-2409
Mailing address:
  • Phone: 267-277-3707
  • Fax: 267-382-2409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: