Provider Demographics
NPI:1407418411
Name:JONES, INGRID WALLACH (LISW)
Entity Type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:WALLACH
Last Name:JONES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1491
Mailing Address - Country:US
Mailing Address - Phone:513-272-2800
Mailing Address - Fax:513-272-2807
Practice Address - Street 1:5050 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1491
Practice Address - Country:US
Practice Address - Phone:513-272-2800
Practice Address - Fax:513-272-2807
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23041811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical