Provider Demographics
NPI:1831527936
Name:JONES, PHILIP (LSW)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 N WILLOW ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-4785
Mailing Address - Country:US
Mailing Address - Phone:702-346-4696
Mailing Address - Fax:702-346-4699
Practice Address - Street 1:61 N WILLOW ST
Practice Address - Street 2:SUITE 4
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-4785
Practice Address - Country:US
Practice Address - Phone:702-346-4696
Practice Address - Fax:702-346-4699
Is Sole Proprietor?:No
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2087-S104100000X, 171M00000X, 225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV88-6000022OtherSTATE OF NEVADA