Provider Demographics
NPI:1851151625
Name:JONES, CHANIQUA (LCSW)
Entity Type:Individual
Prefix:
First Name:CHANIQUA
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 1:302 SAG HARBOR PL
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23075-1664
Mailing Address - Country:US
Mailing Address - Phone:757-717-1434
Mailing Address - Fax:
Practice Address - Street 1:107 S 5TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3825
Practice Address - Country:US
Practice Address - Phone:804-819-4000
Practice Address - Fax:804-819-5221
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040164461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical