Provider Demographics
NPI:1982086039
Name:JONES, KACI LILLIE (LCSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:KACI
Middle Name:LILLIE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-4564
Mailing Address - Country:US
Mailing Address - Phone:816-737-1724
Mailing Address - Fax:
Practice Address - Street 1:8701 TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64138-4564
Practice Address - Country:US
Practice Address - Phone:816-737-1724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110377541041C0700X
DCLC500792531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical