Provider Demographics
NPI:1275062077
Name:JONES, IESHA (BSW LSW)
Entity Type:Individual
Prefix:
First Name:IESHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:BSW LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-3307
Mailing Address - Country:US
Mailing Address - Phone:903-920-7781
Mailing Address - Fax:
Practice Address - Street 1:1011 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-3307
Practice Address - Country:US
Practice Address - Phone:903-589-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-06
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS16012891041C0700X
TX1061031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical