Provider Demographics
NPI:1841015377
Name:JONES, CHARLATTA V (LADC, LMSW)
Entity type:Individual
Prefix:MS
First Name:CHARLATTA
Middle Name:V
Last Name:JONES
Suffix:
Gender:F
Credentials:LADC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-2313
Mailing Address - Country:US
Mailing Address - Phone:203-500-6278
Mailing Address - Fax:
Practice Address - Street 1:1789 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-3317
Practice Address - Country:US
Practice Address - Phone:860-754-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001459101YA0400X
CT9223104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker