Provider Demographics
NPI:1124170147
Name:JONES, PURLEY S (MSW)
Entity type:Individual
Prefix:
First Name:PURLEY
Middle Name:S
Last Name:JONES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41329
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-0729
Mailing Address - Country:US
Mailing Address - Phone:202-293-2791
Mailing Address - Fax:202-529-5792
Practice Address - Street 1:3739 12TH ST NE
Practice Address - Street 2:SUITE 1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2539
Practice Address - Country:US
Practice Address - Phone:202-293-2791
Practice Address - Fax:202-529-5792
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07303101YM0800X
DCLC302104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health