Provider Demographics
NPI:1346443009
Name:SPIERS-JONES, PAMELA J (LCSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:SPIERS-JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 768
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-0768
Mailing Address - Country:US
Mailing Address - Phone:601-684-2173
Mailing Address - Fax:601-249-4234
Practice Address - Street 1:1701 WHITE ST
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2711
Practice Address - Country:US
Practice Address - Phone:601-684-2173
Practice Address - Fax:601-249-4234
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR822341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSR82234OtherUPIN
MS00830207Medicaid
MS00830207Medicaid