Provider Demographics
NPI:1740401256
Name:JONES, CYNTHIA A (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LAUREL TERRACE
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481
Mailing Address - Country:US
Mailing Address - Phone:781-235-5301
Mailing Address - Fax:
Practice Address - Street 1:275 TURNPIKE STREET
Practice Address - Street 2:SUITE 105
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021
Practice Address - Country:US
Practice Address - Phone:781-821-1516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10158441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO4658Medicare ID - Type Unspecified