Provider Demographics
NPI:1447688247
Name:AGNE JONES, JOYCE ANN (LSW)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:ANN
Last Name:AGNE JONES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:JOYCE
Other - Middle Name:ANN
Other - Last Name:AGNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:P.O. BOX 683
Mailing Address - Street 2:165 EAST PARK AVENUE
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446
Mailing Address - Country:US
Mailing Address - Phone:330-544-8005
Mailing Address - Fax:330-544-9379
Practice Address - Street 1:165 EAST PARK AVENUE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446
Practice Address - Country:US
Practice Address - Phone:330-544-8005
Practice Address - Fax:330-544-9379
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1440371104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846675Medicaid