Provider Demographics
NPI:1710425079
Name:TARA JONES FAMILY COUNSELING SOLUTIONS
Entity Type:Organization
Organization Name:TARA JONES FAMILY COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-515-9233
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:PAISLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97636-0292
Mailing Address - Country:US
Mailing Address - Phone:541-515-9233
Mailing Address - Fax:
Practice Address - Street 1:723 CHEWAUCAN ST
Practice Address - Street 2:
Practice Address - City:PAISLEY
Practice Address - State:OR
Practice Address - Zip Code:97636
Practice Address - Country:US
Practice Address - Phone:541-515-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL66981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR188448CAHMedicare PIN