Provider Demographics
NPI:1528768447
Name:JONES, KIMBERLY YVETTE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:YVETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13747 HARVEST GLEN WAY # 3
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-6252
Mailing Address - Country:US
Mailing Address - Phone:240-946-0243
Mailing Address - Fax:
Practice Address - Street 1:13747 HARVEST GLEN WAY # 3
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-6252
Practice Address - Country:US
Practice Address - Phone:240-946-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health