Provider Demographics
NPI:1295991099
Name:MARK R. JONES, LCSW, LLC
Entity type:Organization
Organization Name:MARK R. JONES, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW, LSCW
Authorized Official - Phone:412-244-0960
Mailing Address - Street 1:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-0053
Mailing Address - Country:US
Mailing Address - Phone:412-244-0960
Mailing Address - Fax:800-811-0983
Practice Address - Street 1:700 S TRENTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3477
Practice Address - Country:US
Practice Address - Phone:412-244-0960
Practice Address - Fax:800-811-0983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW001690L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA641940OtherHIGHMARK BLUE SHIELD
PA9P587OtherEMPIRE
PA641940Medicare PIN