Provider Demographics
NPI:1508119538
Name:JONES, CHRISTINE M (LICSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4736 ROYAL AVE
Mailing Address - Street 2:PMB 109169
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402
Mailing Address - Country:US
Mailing Address - Phone:360-232-3906
Mailing Address - Fax:
Practice Address - Street 1:4055 ROYAL AVE SPC 27
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-6820
Practice Address - Country:US
Practice Address - Phone:360-232-3906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL146101041C0700X
WA606186731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical