Provider Demographics
NPI:1598047284
Name:JONES, PAULA DENISE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4818
Mailing Address - Country:US
Mailing Address - Phone:443-742-9181
Mailing Address - Fax:410-545-0178
Practice Address - Street 1:600 REISTERSTOWN RD
Practice Address - Street 2:SUITE 404
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5104
Practice Address - Country:US
Practice Address - Phone:443-588-5048
Practice Address - Fax:443-853-1895
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD048721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD14838Medicaid