Provider Demographics
NPI:1568603710
Name:JONES, ELLEN MURRAY (LICSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:MURRAY
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:544 BAY RD
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5220
Mailing Address - Country:US
Mailing Address - Phone:781-934-0276
Mailing Address - Fax:
Practice Address - Street 1:125 CHURCH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1929
Practice Address - Country:US
Practice Address - Phone:781-864-2473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1142981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical