Provider Demographics
NPI:1841496973
Name:JONES, MONIQUE BRUNSON (LCSW)
Entity type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:BRUNSON
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1056
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60690-1056
Mailing Address - Country:US
Mailing Address - Phone:773-608-9311
Mailing Address - Fax:
Practice Address - Street 1:564 W RANDOLPH ST
Practice Address - Street 2:SUITE 231
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-2218
Practice Address - Country:US
Practice Address - Phone:773-608-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490113441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical