Provider Demographics
NPI:1518019009
Name:JONES, KIMBERLY KAY (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:KAY
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 1:344 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:VA
Mailing Address - Zip Code:23890-3235
Mailing Address - Country:US
Mailing Address - Phone:804-834-8871
Mailing Address - Fax:804-834-8875
Practice Address - Street 1:344 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:VA
Practice Address - Zip Code:23890-3235
Practice Address - Country:US
Practice Address - Phone:804-834-8871
Practice Address - Fax:804-834-8875
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008937311Medicaid
VA3207051OtherAETNA PROVIDER NUMBER
VA089543OtherSENTARA PROVIDER NUMBER
VA435332OtherANTHEM PROVIDER NUMBER