Provider Demographics
NPI:1073340477
Name:JONES, EUGENE L
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:L
Last Name:JONES
Suffix:
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:PO BOX 181124
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-0012
Mailing Address - Country:US
Mailing Address - Phone:617-541-9900
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 181124
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-0012
Practice Address - Country:US
Practice Address - Phone:617-306-6812
Practice Address - Fax:617-307-9024
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical