Provider Demographics
NPI:1356556377
Name:JONES, JOANNA A (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:A
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 1:11806 AMBLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-1502
Mailing Address - Country:US
Mailing Address - Phone:713-826-5032
Mailing Address - Fax:
Practice Address - Street 1:4434 BLUEBONNET DR
Practice Address - Street 2:SUITE #116
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2904
Practice Address - Country:US
Practice Address - Phone:713-826-5032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0026PBOtherBCBS
TX1812240Medicaid