Provider Demographics
NPI:1932807195
Name:JONES, SOPHIA (CPS, CASAC-T)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CPS, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 POND HILL LN
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2264
Mailing Address - Country:US
Mailing Address - Phone:845-707-6106
Mailing Address - Fax:
Practice Address - Street 1:4 POND HILL LN
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-2264
Practice Address - Country:US
Practice Address - Phone:845-281-3239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist