Provider Demographics
NPI:1235649807
Name:TEENA JONES,LICSW, PLLC
Entity Type:Organization
Organization Name:TEENA JONES,LICSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-232-3906
Mailing Address - Street 1:4736 ROYAL AVE
Mailing Address - Street 2:PMB 109169
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402
Mailing Address - Country:US
Mailing Address - Phone:360-232-3906
Mailing Address - Fax:
Practice Address - Street 1:4055 ROYAL AVE SPC 27
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-6820
Practice Address - Country:US
Practice Address - Phone:360-232-3906
Practice Address - Fax:888-211-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)