Provider Demographics
NPI:1912408600
Name:JONES, DELONTE TREQUAN (BCBA)
Entity type:Individual
Prefix:
First Name:DELONTE
Middle Name:TREQUAN
Last Name:JONES
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 KATHANN DR # B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-1254
Mailing Address - Country:US
Mailing Address - Phone:434-610-9856
Mailing Address - Fax:
Practice Address - Street 1:149 KATHANN DR # B
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605-1254
Practice Address - Country:US
Practice Address - Phone:434-610-9856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000335106E00000X
251C00000X
VA251C00000X
VA0133002510103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No251C00000XAgenciesDay Training, Developmentally Disabled Services