Provider Demographics
NPI:1699951194
Name:JONES, CHARLES STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:STEVEN
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 1:7 FOREST CT
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5002
Mailing Address - Country:US
Mailing Address - Phone:865-588-7080
Mailing Address - Fax:646-390-7913
Practice Address - Street 1:7 FOREST CT
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5002
Practice Address - Country:US
Practice Address - Phone:865-588-7080
Practice Address - Fax:646-390-7913
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1219103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN77334OtherBCBS OF TN