Provider Demographics
NPI:1679881700
Name:ABIGAIL BROWN JONES
Entity type:Organization
Organization Name:ABIGAIL BROWN JONES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE & FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:702-290-7653
Mailing Address - Street 1:4425 S JONES BLVD
Mailing Address - Street 2:STE. D-3
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3370
Mailing Address - Country:US
Mailing Address - Phone:702-290-7653
Mailing Address - Fax:702-566-4575
Practice Address - Street 1:4425 S JONES BLVD
Practice Address - Street 2:STE. D-3
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3370
Practice Address - Country:US
Practice Address - Phone:702-290-7653
Practice Address - Fax:702-566-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01065106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1235140963Medicaid