Provider Demographics
NPI:1063896140
Name:JONES, CYNTHIA CAROLETTE
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:CAROLETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:CAROLETTE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3754 SILVER PARK CT
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-3039
Mailing Address - Country:US
Mailing Address - Phone:301-778-8391
Mailing Address - Fax:240-712-5681
Practice Address - Street 1:6120 GOTHIC LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-5305
Practice Address - Country:US
Practice Address - Phone:301-456-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14698101YP2500X
MDLC6163101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional