Provider Demographics
NPI:1861671430
Name:JONES, LISA MCDADE (MSP, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MCDADE
Last Name:JONES
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-3538
Mailing Address - Country:US
Mailing Address - Phone:843-849-2838
Mailing Address - Fax:843-849-2884
Practice Address - Street 1:75 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-3538
Practice Address - Country:US
Practice Address - Phone:843-849-2838
Practice Address - Fax:843-849-2884
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2014-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1040235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist