Provider Demographics
NPI:1164201216
Name:JONES, NIA MARIA (P019769)
Entity Type:Individual
Prefix:
First Name:NIA
Middle Name:MARIA
Last Name:JONES
Suffix:
Gender:F
Credentials:P019769
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 S WESTGATE DR STE D
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1632
Mailing Address - Country:US
Mailing Address - Phone:866-700-1606
Mailing Address - Fax:866-338-4921
Practice Address - Street 1:319 S WESTGATE DR STE D
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1632
Practice Address - Country:US
Practice Address - Phone:866-700-1606
Practice Address - Fax:866-338-4921
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0197691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical