Provider Demographics
NPI:1366420119
Name:JONES, PAULETTE (ED M MS)
Entity type:Individual
Prefix:MS
First Name:PAULETTE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:ED M MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E 46TH ST
Mailing Address - Street 2:12K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-3033
Mailing Address - Country:US
Mailing Address - Phone:212-297-0219
Mailing Address - Fax:212-883-8258
Practice Address - Street 1:330 E 46TH ST
Practice Address - Street 2:12K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3033
Practice Address - Country:US
Practice Address - Phone:212-297-0219
Practice Address - Fax:212-883-8258
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000036101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health