Doctor Name: | WAYNE ALLEN JONES |
NPI Number: | 1255505301 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC, MA |
License Number: | 180.007101 |
Business Practice Address: | 621 Plainfield Rd 110 Willowbrook, IL - 605275343 |
Business Phone Number: | 7737934095 |
Business Fax Number: | |
Mailing Address: | 1112 N Ashland Ave, 1r CHICAGO |
State: | IL |
Postal Code: | 606223935 |
Phone Number: | 7737934095 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2008 |
NPI Last Update Date: | 04/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180.007101 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |