Provider Demographics
NPI:1659598837
Name:JONES, SUSAN ANNETTE (BA, CADC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ANNETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:BA, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6811 EAST 87TH STREET
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5052
Mailing Address - Country:US
Mailing Address - Phone:918-494-0194
Mailing Address - Fax:
Practice Address - Street 1:2 NORTH WATER
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066
Practice Address - Country:US
Practice Address - Phone:918-224-0225
Practice Address - Fax:918-224-5975
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)