Provider Demographics
NPI:1821408717
Name:JONES, TANEILIA (LCSW)
Entity Type:Individual
Prefix:
First Name:TANEILIA
Middle Name:
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 1:167 HAVERFORD CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5755
Mailing Address - Country:US
Mailing Address - Phone:757-717-6353
Mailing Address - Fax:
Practice Address - Street 1:2019 CUNNINGHAM DR STE 101
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3316
Practice Address - Country:US
Practice Address - Phone:757-717-6353
Practice Address - Fax:757-251-6467
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040084641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical