Provider Demographics
NPI:1689731150
Name:JONES, KAATRI LYNNE (LICSW, ESA)
Entity Type:Individual
Prefix:
First Name:KAATRI
Middle Name:LYNNE
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW, ESA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 E MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1322
Mailing Address - Country:US
Mailing Address - Phone:360-927-2655
Mailing Address - Fax:
Practice Address - Street 1:1120 E MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1322
Practice Address - Country:US
Practice Address - Phone:360-927-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1041S0200X, 1041S0200X
WALW 605364191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical