Provider Demographics
NPI:1194020750
Name:JONES, ALISON (LCSW, QMHP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 NW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3609
Mailing Address - Country:US
Mailing Address - Phone:503-200-3923
Mailing Address - Fax:503-241-7419
Practice Address - Street 1:33 NW BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-0000
Practice Address - Country:US
Practice Address - Phone:503-228-7134
Practice Address - Fax:503-445-0749
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60111151101Y00000X
101YM0800X
ORL51211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health