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General NPI Number Information
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NPI Number | 1376140038
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Entity Type | Individual
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Provider Name | LAKEISHA SADE JONES
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Gender | Female
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 5022 CAMPBELL BLVD STE 4969
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4969
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Country | US
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Telephone | 443-442-1538
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Fax |
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Provider Business Mailing Address
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Address Line | 3302 CLARKS LN APT E
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City | BALTIMORE
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State | MD
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Zip | 21215-2620
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Country | US
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Telephone | 253-921-2596
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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 | 26132
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License Number State | MD
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