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General NPI Number Information
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NPI Number | 1538615562
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Entity Type | Individual
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Provider Name | NICOLE JONAS
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Gender | Female
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 09/20/2024
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Provider Practice Location Address
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Address Line | 929 S WASHINGTON ST
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City | JUNCTION CITY
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State | KS
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Zip | 66441-3805
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Country | US
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Telephone | 785-802-9084
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Fax |
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Provider Business Mailing Address
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Address Line | 366 LIBBY AVE
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City | HOPEWELL
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State | VA
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Zip | 23860-4039
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Country | US
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Telephone | 785-408-6191
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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 | 0904012957
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05694
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C011555
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License Number State | NC
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