Provider Demographics
NPI:1063104990
Name:JONES, KATELYN R (MSW, NMT LEVEL I)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:R
Last Name:JONES
Suffix:
Gender:X
Credentials:MSW, NMT LEVEL I
Other - Prefix:
Other - First Name:YOLI
Other - Middle Name:R
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:931 CHEVY WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4127
Mailing Address - Country:US
Mailing Address - Phone:541-840-4086
Mailing Address - Fax:
Practice Address - Street 1:745 N ROSE ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:OR
Practice Address - Zip Code:97535-5704
Practice Address - Country:US
Practice Address - Phone:541-535-6239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical