Provider Demographics
NPI:1679642524
Name:JONES, JUDI K (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDI
Middle Name:K
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:KERSTETTER
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8017 BEAUMONT GREEN EAST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250
Mailing Address - Country:US
Mailing Address - Phone:317-595-8994
Mailing Address - Fax:317-853-1314
Practice Address - Street 1:10291 N MERIDIAN ST
Practice Address - Street 2:#160
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290
Practice Address - Country:US
Practice Address - Phone:317-595-8994
Practice Address - Fax:317-853-1314
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003233A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
123531OtherMHN MANAGED HEALTH NETWOR
7145134OtherAETNA
000000183101OtherANTHEM