Doctor Name: | MRS. MARY EILEEN SOUTHWICK JONES |
NPI Number: | 1033288824 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | SW6913 |
Business Practice Address: | 1405 Park Ave Suite 202 Fernandina Beach, FL - 32034 |
Business Phone Number: | 9042772052 |
Business Fax Number: | 9042772083 |
Mailing Address: | 3947 Cattail Pond Drive, JACKSONVILLE |
State: | FL |
Postal Code: | 32224 |
Phone Number: | 9043742863 |
Fax Number: | |
NPI Enumeration Date: | 11/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SW6913 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |