Provider Demographics
NPI:1982849402
Name:JONES, KELLY A (LICSW)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:JONES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PENNSYLVANIA AVENUE, SE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2167
Mailing Address - Country:US
Mailing Address - Phone:202-546-1512
Mailing Address - Fax:202-544-5365
Practice Address - Street 1:801 PENNSYLVANIA AVE SE
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-2167
Practice Address - Country:US
Practice Address - Phone:202-546-1512
Practice Address - Fax:202-544-5365
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500779491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical