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Provider Information for 1225033400


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ROBERT E JONES Jr. LCSW


Sex: Male

NPI: 1225033400
Last Updated: 2024-08-28
Certification Date: 2024-08-20

Details

NameValue
NPI1225033400
Enumeration Date2005-06-15
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 7837 COLONIAL SPRINGS BLVD
ALEXANDRIA, VA 22306-2850
United States

Phone: 202-253-0410 | Fax:
 
Primary Practice Address 6045 SOLOMONS ISLAND RD
HUNTINGTOWN, MD 20639-8876
United States

Phone: 410-257-5200 | Fax:410-257-2442
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDMD406024500
Other (non-Medicare)560946-000Magellan Behav. Health
Other (non-Medicare)642820-01CareFirst BC/BS-MD
Other (non-Medicare)F453-0006CareFirst BlueChoice
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalVA0904016797
No 1041C0700X - Social Worker - ClinicalDCLC50078352