Provider Demographics
NPI:1720299894
Name:JONES, DIONNA LEE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DIONNA
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:DIONNA
Other - Middle Name:LEE
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6041 SIRENIA PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4351
Mailing Address - Country:US
Mailing Address - Phone:240-412-0992
Mailing Address - Fax:
Practice Address - Street 1:2670 CRAIN HWY
Practice Address - Street 2:SUITE 402
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2806
Practice Address - Country:US
Practice Address - Phone:301-396-4105
Practice Address - Fax:301-396-5733
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD112331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11233Medicaid
MD11233Medicaid