1194904391 NPI number — CAROL A. JONES, L.C.S.W.,L.L.C.

Table of content: (NPI 1194904391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194904391 NPI number — CAROL A. JONES, L.C.S.W.,L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROL A. JONES, L.C.S.W.,L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194904391
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 BRAXTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLE MEAD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08502-4602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-359-1411
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2186 ROUTE 27
Provider Second Line Business Practice Location Address:
SUITE 2A
Provider Business Practice Location Address City Name:
NORTH BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08902-1137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-422-0800
Provider Business Practice Location Address Fax Number:
732-422-2485
Provider Enumeration Date:
10/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
732-422-0800

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC04376800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)