Provider Demographics
NPI:1437603032
Name:JONES, VICTORIA LAURINE (LCSW)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LAURINE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:LAURINE
Other - Last Name:MAHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:52 TIMBER CREEK DR STE 203
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4388
Mailing Address - Country:US
Mailing Address - Phone:901-440-8580
Mailing Address - Fax:
Practice Address - Street 1:52 TIMBER CREEK DR STE 203
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4388
Practice Address - Country:US
Practice Address - Phone:901-440-8580
Practice Address - Fax:888-977-2994
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1215314562Medicaid