Provider Demographics
NPI:1083010300
Name:JONES, SUSAN L (LCSW, LAC, MSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW, LAC, MSW
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:L
Other - Last Name:DOKTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, LAC, MSW
Mailing Address - Street 1:4856 INNOVATION DR STE B
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5540
Mailing Address - Country:US
Mailing Address - Phone:970-494-4200
Mailing Address - Fax:
Practice Address - Street 1:1250 N WILSON AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4461
Practice Address - Country:US
Practice Address - Phone:970-494-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0000870101YA0400X
COCSW.099252411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)