Provider Demographics
NPI:1447679121
Name:JONES, BEVERLY (MFT, CAMS, ST, PP)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MFT, CAMS, ST, PP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-3930
Mailing Address - Country:US
Mailing Address - Phone:478-747-9459
Mailing Address - Fax:478-475-9492
Practice Address - Street 1:6601 ZEBULON RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31220-7606
Practice Address - Country:US
Practice Address - Phone:478-477-3383
Practice Address - Fax:478-475-9492
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health