Provider Demographics
NPI:1134467624
Name:JONES, COURTNEY SHERMANE (LMSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SHERMANE
Last Name:JONES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-1627
Mailing Address - Country:US
Mailing Address - Phone:803-810-8400
Mailing Address - Fax:803-222-8043
Practice Address - Street 1:300 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:CLOVER
Practice Address - State:SC
Practice Address - Zip Code:29710-1627
Practice Address - Country:US
Practice Address - Phone:803-810-8400
Practice Address - Fax:803-222-8043
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC83801041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool