Provider Demographics
NPI:1588820146
Name:JONES, JUDITH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:9780 E INDIGO ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5609
Mailing Address - Country:US
Mailing Address - Phone:305-232-6003
Mailing Address - Fax:305-232-6092
Practice Address - Street 1:9780 E INDIGO ST
Practice Address - Street 2:SUITE 301
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-5609
Practice Address - Country:US
Practice Address - Phone:305-232-6003
Practice Address - Fax:305-232-6092
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW22251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL766064200Medicaid
FL766618700Medicaid