Provider Demographics
NPI:1851319032
Name:JONES, TOM (LCSW)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3528 US HIGHWAY 9
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3345
Mailing Address - Country:US
Mailing Address - Phone:732-252-8615
Mailing Address - Fax:
Practice Address - Street 1:3528 US HIGHWAY 9
Practice Address - Street 2:SUITE 304
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3345
Practice Address - Country:US
Practice Address - Phone:732-252-8615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052330001041C0700X
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ098696SGNMedicare ID - Type Unspecified
NJ121010Medicare PIN