Provider Demographics
NPI:1548391147
Name:JONES, VIRGINIA O (LCSW)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:O
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NE BRAILLE PL STE 110
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-5345
Mailing Address - Country:US
Mailing Address - Phone:772-320-0792
Mailing Address - Fax:772-320-0181
Practice Address - Street 1:1601 NE BRAILLE PL
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-5345
Practice Address - Country:US
Practice Address - Phone:772-320-0792
Practice Address - Fax:772-320-0181
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW74501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3600339300Medicaid
FL912987100Medicaid
FL766352800Medicaid