Provider Demographics
NPI:1285270413
Name:JONES, KELSEY (LCSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1107 WILLOWBROOK RUN
Mailing Address - Street 2:
Mailing Address - City:AYDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28513-7801
Mailing Address - Country:US
Mailing Address - Phone:252-349-0705
Mailing Address - Fax:
Practice Address - Street 1:233 MIDDLE ST STE 105
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-2101
Practice Address - Country:US
Practice Address - Phone:252-349-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-22
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0137151041C0700X
NCP0131371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical