Provider Demographics
NPI:1457015067
Name:JONAS, GABRIELLE ANNE CLARKE (LCSW)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ANNE CLARKE
Last Name:JONAS
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 1:505 AMORY STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:781-559-4900
Mailing Address - Fax:781-559-4901
Practice Address - Street 1:505 AMORY STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:781-559-4900
Practice Address - Fax:781-559-4901
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical