Individual
MR. MARK JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
248 W 108TH ST FL 2, NEW YORK, NY 10025-2956
(212) 663-3000
Mailing address
248 W 108TH ST FL 2, NEW YORK, NY 10025-2956
(212) 663-3000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
36863
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36863
COMMERCIAL
NY
05
—
36863
—
NY
Enumeration date
02/13/2023
Last updated
02/13/2023
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