Jacqueline Jones, RLCSW

Individual provider Active NPI Clinical Social Worker · Bayport, NY

NPI 1760610901 · NPPES record last updated Jun 25, 2009

Key facts

NPI
1760610901
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R049117-1 (NY)
Practice address
71 Stephen Rd
Bayport, NY 11705-1231
Phone
(631) 512-1844
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R049117-1NYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R049117-1 NY Yes

Addresses

Primary practice location

71 Stephen Rd
Bayport, NY 11705-1231

Mailing address

71 Stephen Rd
Bayport, NY 11705-1231
Phone (631) 512-1844

Other providers in Bayport, NY

All providers in Bayport, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.