Provider Demographics
NPI:1306119904
Name:JONES, JUSTIN RILEY DARLIN (PHD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:RILEY DARLIN
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PERRY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2757
Mailing Address - Country:US
Mailing Address - Phone:917-568-1390
Mailing Address - Fax:
Practice Address - Street 1:8 PERRY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2757
Practice Address - Country:US
Practice Address - Phone:917-568-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019365-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist