Provider Demographics
NPI:1891359238
Name:JONES-MICHAEL, TANIA (LMSW)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:JONES-MICHAEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SADDLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2517
Mailing Address - Country:US
Mailing Address - Phone:516-499-1444
Mailing Address - Fax:
Practice Address - Street 1:41 SADDLE ROCK RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-2517
Practice Address - Country:US
Practice Address - Phone:516-499-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078074104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker