Provider Demographics
NPI:1144085580
Name:JONES, SUSAN (MED-COUNSELING)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MED-COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 LEMON RANCH RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5202
Mailing Address - Country:US
Mailing Address - Phone:405-826-2222
Mailing Address - Fax:
Practice Address - Street 1:6907 NW 122ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-3903
Practice Address - Country:US
Practice Address - Phone:405-623-7163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty