Provider Demographics
NPI:1952684193
Name:JONES, ELIZABETH A (LCSW, BCBA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 BAR GATE TRL
Mailing Address - Street 2:
Mailing Address - City:KILLINGWORTH
Mailing Address - State:CT
Mailing Address - Zip Code:06419-1382
Mailing Address - Country:US
Mailing Address - Phone:860-391-3561
Mailing Address - Fax:
Practice Address - Street 1:1620 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:CT
Practice Address - Zip Code:06498-2094
Practice Address - Country:US
Practice Address - Phone:203-453-7592
Practice Address - Fax:203-453-7538
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015001041C0700X
1-09-6706103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical