Provider Demographics
NPI:1629086251
Name:JONES, DEBRA JO (LCSW, QCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JO
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW, QCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:LEEPER
Mailing Address - State:PA
Mailing Address - Zip Code:16233-2632
Mailing Address - Country:US
Mailing Address - Phone:814-744-9914
Mailing Address - Fax:
Practice Address - Street 1:413 WOOD ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1337
Practice Address - Country:US
Practice Address - Phone:814-223-8696
Practice Address - Fax:814-223-9145
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0139631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical