1881993731 NPI number — URSULA M JONES, LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881993731 NPI number — URSULA M JONES, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
URSULA M JONES, LCSW
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:
1881993731
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 US OVAL
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
PLATTSBURGH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12903-5900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-324-4344
Provider Business Mailing Address Fax Number:
518-324-4344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22 US OVAL
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
PLATTSBURGH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12903-5900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-324-4344
Provider Business Practice Location Address Fax Number:
518-324-4344
Provider Enumeration Date:
03/17/2011

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
URSULA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
LCSW
Authorized Official Telephone Number:
518-324-4344

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R026446 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1245274174 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02875932 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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