Individual provider Active NPI

Tanya N Jones, LCSW, PHD

  • Clinical Social Worker
  • Sanford, NC
National Provider Identifier
1891184008
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4801 Issued in HI
Practice address
500 Westover Dr #13619
Sanford, NC 27330-5001
Phone
(323) 205-7088
Fax
(833) 419-0181
NPI assigned
Jan 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Addiction (Substance Use Disorder) Counselor 101YA0400X 3087-24NR HI
Clinical Social Worker 1041C0700X 4801 HI Primary

Addresses

Primary practice location

500 Westover Dr #13619
Sanford, NC 27330-5001

Mailing address

91-1121 Keaunui Dr Ste 108
Ewa Beach, HI 96706-6365
Phone (808) 551-2228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3087-24NRHIMDAddiction (Substance Use Disorder) Counselor
4801HIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1891184008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1121 KEAUNUI DR STE 108",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967066365",
            "telephone_number": "808-551-2228",
            "fax_number": "808-433-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WESTOVER DR #13619",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273305001",
            "telephone_number": "323-205-7088",
            "fax_number": "833-419-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "TANYA",
        "middle_name": "N",
        "credential": "LCSW, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "HI",
            "license": "3087-24NR",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "4801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

Verify at the official NPI Registry.