Provider Demographics
NPI:1962426130
Name:JONES, JAMES DENISON (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DENISON
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 1:2565 S ROCHESTER RD
Mailing Address - Street 2:SUITE 107B
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4472
Mailing Address - Country:US
Mailing Address - Phone:248-852-7907
Mailing Address - Fax:
Practice Address - Street 1:2565 S ROCHESTER RD
Practice Address - Street 2:SUITE 107B
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4472
Practice Address - Country:US
Practice Address - Phone:248-852-7907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011662103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN98980001Medicare ID - Type UnspecifiedMEDICARE