Provider Demographics
NPI:1245016070
Name:JONES-OGUNSUYI, REGINA D (LCSW)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:D
Last Name:JONES-OGUNSUYI
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 1:5501 SEMINARY RD APT 1504S
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3908
Mailing Address - Country:US
Mailing Address - Phone:773-727-9117
Mailing Address - Fax:
Practice Address - Street 1:7153 S ARTESIAN AVE APT 1504S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-1425
Practice Address - Country:US
Practice Address - Phone:773-727-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149007604104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker