Provider Demographics
NPI:1932459773
Name:JONES, JEANNIE LINDA (MSW LCSW-PIP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNIE
Middle Name:LINDA
Last Name:JONES
Suffix:
Gender:F
Credentials:MSW LCSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 PONDEROSA AVE
Mailing Address - Street 2:
Mailing Address - City:HILL CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57745-6062
Mailing Address - Country:US
Mailing Address - Phone:605-574-9573
Mailing Address - Fax:
Practice Address - Street 1:240 PONDEROSA AVE
Practice Address - Street 2:
Practice Address - City:HILL CITY
Practice Address - State:SD
Practice Address - Zip Code:57745-6062
Practice Address - Country:US
Practice Address - Phone:605-574-9573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD30941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical