Provider Demographics
NPI:1255755765
Name:JONES, RODRICA MICHAEL (PHD,LICSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:RODRICA
Middle Name:MICHAEL
Last Name:JONES
Suffix:
Gender:M
Credentials:PHD,LICSW, LCSW
Other - Prefix:DR
Other - First Name:ROD
Other - Middle Name:MICHAEL
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3350 N DURANGO DR
Mailing Address - Street 2:APT. 2087
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7266
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6900 N PECOS RD, BUILDING 5, RM 2F248
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500799061041C0700X
MD171921041C0700X
NV7061-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical