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General NPI Number Information
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NPI Number | 1902413719
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Entity Type | Individual
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Provider Name | TARA B JONES LISW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 4400 EASTON CMNS STE 125
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City | COLUMBUS
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State | OH
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Zip | 43219-6223
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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Provider Business Mailing Address
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Address Line | PO BOX 11167
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City | FORT WAYNE
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State | IN
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Zip | 46856-1167
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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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 | I.0008386-SUPV
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License Number State | OH
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