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NPI Code Detail

MEDICARE: MRS. TANESHA JONES LCSW

MEDICARE: MRS. TANESHA JONES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker009866CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1009866OTHERCTDEPARTMENT OF PUBLIC HEALTH

General Provider Information

NPI Number : 1578954939
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TANESHA JONES LCSW
Provider Business Mailing Address
First Line : 15 POND ST
Second Line :
City : UNIONVILLE
State : CT
Zip : 06085-1521
Country : US
Telephone Number : 860-922-0561
Fax Number :
Provider Business Practice Location Address
First Line : 1789 NEW BRITAIN AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06032-3317
Country : US
Telephone Number : 860-922-0561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2015
Last Update Date : 10/10/2023

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