Provider Demographics
NPI:1871030072
Name:MCNEIL-JONES, MARY (PHD CACIII)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:MCNEIL-JONES
Suffix:
Gender:F
Credentials:PHD CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 S POTOMAC ST STE 130
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2490
Mailing Address - Country:US
Mailing Address - Phone:720-216-0970
Mailing Address - Fax:720-216-0183
Practice Address - Street 1:380 S POTOMAC ST STE 130
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2490
Practice Address - Country:US
Practice Address - Phone:720-216-0970
Practice Address - Fax:720-216-0183
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0011779103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)