Provider Demographics
NPI:1386385243
Name:JONES, ABBIE (PH D)
Entity type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6133 HILL HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-8650
Mailing Address - Country:US
Mailing Address - Phone:812-240-2835
Mailing Address - Fax:
Practice Address - Street 1:6133 HILL HAVEN RD
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-8650
Practice Address - Country:US
Practice Address - Phone:812-240-2835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043545A103T00000X
IN20043545B103TC0700X, 103TH0100X, 103T00000X
IN10232804103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool