Provider Demographics
NPI:1023069143
Name:JONES, BILLY (LCSW)
Entity type:Individual
Prefix:MR
First Name:BILLY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 NC HWY 42 WEST SUITE 220
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-9405
Mailing Address - Country:US
Mailing Address - Phone:919-550-3323
Mailing Address - Fax:919-550-3379
Practice Address - Street 1:2076 NC HIGHWAY 42 W
Practice Address - Street 2:SUITE 220
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5302
Practice Address - Country:US
Practice Address - Phone:919-550-3323
Practice Address - Fax:919-550-3376
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0031941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002500Medicaid
NC1332JOtherBCBS INDIVIDUAL
NC2871477BMedicare ID - Type UnspecifiedINDIVIDUAL