Provider Demographics
NPI:1871679886
Name:JONES, KRISTIE ANN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:KRISTIE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1 ELM SQUARE
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810
Mailing Address - Country:US
Mailing Address - Phone:978-494-4188
Mailing Address - Fax:
Practice Address - Street 1:1 ELM SQUARE
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810
Practice Address - Country:US
Practice Address - Phone:978-494-4188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1138191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical