Provider Demographics
NPI:1508478009
Name:JONES, KORA (LISW)
Entity type:Individual
Prefix:
First Name:KORA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:KORA
Other - Middle Name:
Other - Last Name:WETZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:750 ABBE RD S
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-7246
Mailing Address - Country:US
Mailing Address - Phone:440-323-5121
Mailing Address - Fax:
Practice Address - Street 1:750 ABBE RD S
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-7246
Practice Address - Country:US
Practice Address - Phone:440-323-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.24055851041C0700X
OH172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical