Provider Demographics
NPI:1184142945
Name:JONES, EMILY M (LCSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 40TH AVE S STE 120
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4444
Mailing Address - Country:US
Mailing Address - Phone:701-715-8567
Mailing Address - Fax:701-540-0098
Practice Address - Street 1:4675 40TH AVE S STE 120
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4444
Practice Address - Country:US
Practice Address - Phone:701-715-8567
Practice Address - Fax:701-540-0098
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND50291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical