Provider Demographics
NPI:1740513779
Name:JONES, DOLORES (LCMHC)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 EDGEMERE RD
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3516
Mailing Address - Country:US
Mailing Address - Phone:833-446-8773
Mailing Address - Fax:
Practice Address - Street 1:217 W 111TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-4198
Practice Address - Country:US
Practice Address - Phone:833-446-8773
Practice Address - Fax:732-807-4222
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15049900163W00000X
NY00574487163W00000X
NY18PO5723101YM0800X
NY574487163WA0400X, 163WC0400X, 163WH0200X, 163WP0808X, 163WR0400X
NY012111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation