=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972082246
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY JONES LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2018
-----------------------------------------------------
Last Update Date | 01/04/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1801 OBERLIN RD STE 311
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17057-2998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-971-0529
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1801 OBERLIN RD STE 311
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17057-2998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-971-0529
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 135385
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CW023152
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------