Provider Demographics
NPI:1871228668
Name:JONES, JOLISA SHANAY (LBSW)
Entity type:Individual
Prefix:
First Name:JOLISA
Middle Name:SHANAY
Last Name:JONES
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9714 FOREST LN UNIT 6004
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5729
Mailing Address - Country:US
Mailing Address - Phone:254-203-3991
Mailing Address - Fax:
Practice Address - Street 1:9714 FOREST LN UNIT 6004
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5729
Practice Address - Country:US
Practice Address - Phone:254-203-3991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106787104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker