Provider Demographics
NPI:1467962316
Name:JONES, JENNIFER (LSW, CDCA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LSW, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-3710
Mailing Address - Country:US
Mailing Address - Phone:513-615-5134
Mailing Address - Fax:
Practice Address - Street 1:311 ALBERT SABIN WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2838
Practice Address - Country:US
Practice Address - Phone:513-558-9006
Practice Address - Fax:513-558-3880
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS30188104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker