Active NPI
Avon Jones Jr.
- Professional Counselor
- Dover, DE
National Provider Identifier
1376948208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0000703
- Practice address
- 468 Brookfield Dr
Dover, DE 19901-6406 - Phone
- (302) 359-5510
- Fax
- (302) 697-4029
- NPI assigned
- Nov 4, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC007600 | PA | |
| Professional Counselor | 101YP2500X | 0000703 | DE | Primary |
Addresses
Primary practice location
468 Brookfield Dr
Dover, DE 19901-6406
Mailing address
415 North Broad Stree
Unit 4a
Middletown, DE 19709
Phone (302) 359-5510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000703 | DE | MD | Professional Counselor |
| PC007600 | PA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First State Behavioral Health Center | Professional | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443744000000",
"number": "1376948208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 NORTH BROAD STREE",
"address_2": "UNIT 4A",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "19709",
"telephone_number": "302-359-5510",
"fax_number": "302-697-4029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "468 BROOKFIELD DR",
"city": "DOVER",
"state": "DE",
"postal_code": "199016406",
"telephone_number": "302-359-5510",
"fax_number": "302-697-4029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "AVON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-04",
"last_updated": "2015-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC007600",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DE",
"license": "0000703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.