Provider Demographics
NPI:1659024925
Name:JONES, SHAKEIVA (ISW, RCSWI)
Entity Type:Individual
Prefix:MS
First Name:SHAKEIVA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:ISW, RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3612 WISPERBREATH LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-1265
Mailing Address - Country:US
Mailing Address - Phone:813-748-0920
Mailing Address - Fax:
Practice Address - Street 1:7823 N DALE MABRY HWY STE 106
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3273
Practice Address - Country:US
Practice Address - Phone:813-570-5803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW165771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical