Provider Demographics
NPI:1659490407
Name:JONES, TIFFANY (MSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:MSW, PHD
Other - Prefix:DR
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:WILLIAMS-JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, PHD
Mailing Address - Street 1:4140 E BASELINE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4413
Mailing Address - Country:US
Mailing Address - Phone:480-717-2403
Mailing Address - Fax:
Practice Address - Street 1:4140 E BASELINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4413
Practice Address - Country:US
Practice Address - Phone:480-717-2403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ126561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL200987838OtherUNICARE
AZ26-4169307OtherEIN
IL9410291Medicare UPIN
IL04932482Medicare UPIN
IL0007979625Medicare UPIN
IL200987838OtherUNICARE