Healthcare Provider Details

I. General information

NPI: 1528975984
Provider Name (Legal Business Name): KEVIN MICHAEL JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 W SHIRLEY AVE STE 206
WARRENTON VA
20186-3083
US

IV. Provider business mailing address

170 W SHIRLEY AVE STE 206
WARRENTON VA
20186-3083
US

V. Phone/Fax

Practice location:
  • Phone: 540-349-4537
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701015660
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: