Provider Demographics
NPI:1063080471
Name:JONES, BRIAN ANTHONY SR
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:JONES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 N SMEDLEY ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19126-2759
Mailing Address - Country:US
Mailing Address - Phone:267-234-2321
Mailing Address - Fax:
Practice Address - Street 1:233 S 6TH ST STE C33
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3763
Practice Address - Country:US
Practice Address - Phone:215-324-9564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health