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General NPI Number Information
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NPI Number | 1306227467
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Entity Type | Individual
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Provider Name | LESLIE RENEE JONES MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 5300 S LABURNUM AVE
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City | HENRICO
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State | VA
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Zip | 23231
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Country | US
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Telephone | 804-447-5713
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Fax |
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Provider Business Mailing Address
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Address Line | 3005 MULBERRY LN UNIT B
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City | GREENVILLE
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State | NC
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Zip | 27858-5861
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Country | US
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Telephone | 252-327-9137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904010640
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License Number State | VA
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