Provider Demographics
NPI:1669081220
Name:JONES, PRECIOUS C
Entity type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:C
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PRECIOUS
Other - Middle Name:C
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 PINE CONE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8686
Mailing Address - Country:US
Mailing Address - Phone:386-302-0058
Mailing Address - Fax:386-302-0643
Practice Address - Street 1:2050 S RIDGEWOOD AVE APT R4
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-8423
Practice Address - Country:US
Practice Address - Phone:386-307-4307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator