Provider Demographics
NPI:1144324567
Name:JONES, NIKOLE SMALLS (LICSW)
Entity type:Individual
Prefix:MRS
First Name:NIKOLE
Middle Name:SMALLS
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
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Other - Credentials:
Mailing Address - Street 1:VA MEDICAL CENTER C/O MENTAL HEALTH SERVICE LINE #116
Mailing Address - Street 2:PERRY POINT VA MEDICAL CENTER AVE D. BUILDING 364
Mailing Address - City:PERRYVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21902
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:410-642-1707
Practice Address - Street 1:VA MEDICAL CENTER C/O MENTAL HEALTH SERVICE LINE #116
Practice Address - Street 2:AVE D. BUILDING 364
Practice Address - City:PERRYVILLE
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:410-642-1707
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2020-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCLC500781171041C0700X
MD177531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical