Provider Demographics
NPI:1154532067
Name:JONES, H. KIMBALL (PHD, LMHC)
Entity type:Individual
Prefix:DR
First Name:H.
Middle Name:KIMBALL
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 RIVERSIDE DR
Mailing Address - Street 2:10-E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2759
Mailing Address - Country:US
Mailing Address - Phone:212-662-8749
Mailing Address - Fax:212-531-4310
Practice Address - Street 1:2095 BROADWAY
Practice Address - Street 2:ROOM 406
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2895
Practice Address - Country:US
Practice Address - Phone:212-580-7974
Practice Address - Fax:212-531-4310
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLMHC 002235101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral