Provider Demographics
NPI:1447733803
Name:JONES, KYLI MARSHALL (LCSW)
Entity Type:Individual
Prefix:
First Name:KYLI
Middle Name:MARSHALL
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 1:5 BARNES INDUSTRIAL RD S
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2431
Mailing Address - Country:US
Mailing Address - Phone:203-284-0441
Mailing Address - Fax:
Practice Address - Street 1:5 BARNES INDUSTRIAL RD S
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2431
Practice Address - Country:US
Practice Address - Phone:203-284-0441
Practice Address - Fax:203-774-5716
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0101941041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool