Provider Demographics
NPI:1437594249
Name:JONES, STACY EILEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:EILEEN
Last Name: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 1:140 JASON CT
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-4222
Mailing Address - Country:US
Mailing Address - Phone:615-738-8557
Mailing Address - Fax:
Practice Address - Street 1:140 JASON CT
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-4222
Practice Address - Country:US
Practice Address - Phone:615-738-8557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2021-04-08
Deactivation Date:2021-03-17
Deactivation Code:
Reactivation Date:2021-04-07
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN71991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health