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General NPI Number Information
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NPI Number | 1447702857
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Entity Type | Individual
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Provider Name | RICHARD JONES MDIV, LMHC
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Gender | Male
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 819 EAST 64TH STREET #216
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-6610
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Country | US
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Telephone | 317-408-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 10014 NORTHWIND DRIVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-9339
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Country | US
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Telephone | 317-408-8880
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 39002124A
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License Number State | IN
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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 | 39002124A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 39002124A
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License Number State | IN
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