Provider Demographics
NPI:1871170977
Name:JONES, TRISHA LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:LYNN
Last Name:JONES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 W GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-1331
Mailing Address - Country:US
Mailing Address - Phone:563-340-3946
Mailing Address - Fax:
Practice Address - Street 1:3421 W GARFIELD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-1331
Practice Address - Country:US
Practice Address - Phone:563-340-3946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06205104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker