Provider Demographics
NPI:1740814367
Name:JONES, LATONUIA PATRICE (LMSW)
Entity type:Individual
Prefix:DR
First Name:LATONUIA
Middle Name:PATRICE
Last Name:JONES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 RIDGECROFT RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-5030
Mailing Address - Country:US
Mailing Address - Phone:703-220-8400
Mailing Address - Fax:
Practice Address - Street 1:4004 RIDGECROFT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-5030
Practice Address - Country:US
Practice Address - Phone:703-220-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE657674104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty