Provider Demographics
NPI:1598317620
Name:JONES, NICOLE E (CPC, CBT)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:E
Last Name:JONES
Suffix:
Gender:F
Credentials:CPC, CBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 76TH ST SW
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-6350
Mailing Address - Country:US
Mailing Address - Phone:360-510-5722
Mailing Address - Fax:
Practice Address - Street 1:5020 COLLEGE AVE APT B
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-3257
Practice Address - Country:US
Practice Address - Phone:360-510-5722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No175T00000XOther Service ProvidersPeer Specialist