Provider Demographics
NPI:1669688859
Name:JONES, MARTHA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CAMDEN BYP
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36726-1751
Mailing Address - Country:US
Mailing Address - Phone:334-682-4499
Mailing Address - Fax:334-682-4615
Practice Address - Street 1:45 CAMDEN BYP
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AL
Practice Address - Zip Code:36726-1751
Practice Address - Country:US
Practice Address - Phone:334-682-4499
Practice Address - Fax:334-682-4615
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2075C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2075COtherAL - LCSW LICENSE #