Provider Demographics
NPI:1558969287
Name:JONES, TABITHA (MSW)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:SUE
Other - Last Name:COTTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:208 HEWITT DR STE 103 #218
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6693
Mailing Address - Country:US
Mailing Address - Phone:512-686-6012
Mailing Address - Fax:512-842-7227
Practice Address - Street 1:345 OWEN LANE SUITE 102
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710
Practice Address - Country:US
Practice Address - Phone:512-686-6012
Practice Address - Fax:512-842-7227
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX653331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical