Individual
MISS KIMBERLY KAY JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
344 W MAIN ST, WAVERLY, VA 23890-3235
(804) 834-8871
(804) 834-8875
Mailing address
344 W MAIN ST, WAVERLY, VA 23890-3235
(804) 834-8871
(804) 834-8875
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008937311
—
VA
01
—
089543
SENTARA PROVIDER NUMBER
VA
01
—
3207051
AETNA PROVIDER NUMBER
VA
01
—
435332
ANTHEM PROVIDER NUMBER
VA
Enumeration date
01/17/2007
Last updated
03/17/2018
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