Provider Demographics
NPI:1104358241
Name:JONES, DERIC (BSW)
Entity Type:Individual
Prefix:
First Name:DERIC
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4936 TOURO ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4072
Mailing Address - Country:US
Mailing Address - Phone:504-621-8602
Mailing Address - Fax:504-609-3366
Practice Address - Street 1:615 BARONNE ST STE 304
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1054
Practice Address - Country:US
Practice Address - Phone:504-814-8001
Practice Address - Fax:504-609-3366
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator