Provider Demographics
NPI:1730446451
Name:JONES, KATINA DENISE (LISW)
Entity type:Individual
Prefix:MRS
First Name:KATINA
Middle Name:DENISE
Last Name:JONES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 YELLOW ROSE CT
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-9006
Mailing Address - Country:US
Mailing Address - Phone:864-409-7049
Mailing Address - Fax:
Practice Address - Street 1:301 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4022
Practice Address - Country:US
Practice Address - Phone:864-283-0637
Practice Address - Fax:864-283-0638
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC100081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical