Provider Demographics
NPI:1790819696
Name:JONES, TAMI SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:SUE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7116 W ASHLAND DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-1807
Mailing Address - Country:US
Mailing Address - Phone:208-724-8432
Mailing Address - Fax:
Practice Address - Street 1:7711 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83714-6182
Practice Address - Country:US
Practice Address - Phone:208-853-8536
Practice Address - Fax:208-853-2929
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-861101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health