Provider Demographics
NPI:1679164008
Name:JONES, KELDIN PATRICIA (LCSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:KELDIN
Middle Name:PATRICIA
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9292 LEE ROAD 175
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AL
Mailing Address - Zip Code:36874-2729
Mailing Address - Country:US
Mailing Address - Phone:334-332-2739
Mailing Address - Fax:
Practice Address - Street 1:9292 LEE ROAD 175
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:AL
Practice Address - Zip Code:36874-2729
Practice Address - Country:US
Practice Address - Phone:334-332-2739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0064481041C0700X
AL3585C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty