Provider Demographics
NPI:1366619165
Name:JONES, SCOTT S (PHD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:S
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 13TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3840
Mailing Address - Country:US
Mailing Address - Phone:706-324-2050
Mailing Address - Fax:706-324-2088
Practice Address - Street 1:1661 13TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3840
Practice Address - Country:US
Practice Address - Phone:706-324-2050
Practice Address - Fax:706-324-2088
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009065103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical