Healthcare Provider Details

I. General information

NPI: 1740655307
Provider Name (Legal Business Name): GLORIA JEAN JONES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6541 SPECKER AVE BLDG 1830
FT CARSON CO
80913-4263
US

IV. Provider business mailing address

6541 SPECKER AVE BLDG 1830
FT CARSON CO
80913-4263
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-7155
  • Fax:
Mailing address:
  • Phone: 719-526-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09924102
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: