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General NPI Number Information
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NPI Number | 1437378817
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Entity Type | Individual
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Provider Name | THEODORE JONES LPCMH, LCDP, CADC
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 3519 SILVERSIDE RD RIDGELY BLDG, STE 101B
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City | WILMINGTON
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State | DE
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Zip | 19810-4909
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Country | US
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Telephone | 302-598-3831
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Fax | 302-691-3660
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Provider Business Mailing Address
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Address Line | 3519 SILVERSIDE ROAD RIDGELY BLDG, STE 101B
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City | WILMINGTON
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State | DE
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Zip | 19810
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Country | US
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Telephone | 302-598-3831
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCDP #12
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCMH #287
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License Number State | DE
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