Provider Demographics
NPI:1306691134
Name:MOORE-JONES, KIMBERLY PATRICE (LCSW, ACSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:PATRICE
Last Name:MOORE-JONES
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ROBINS PL
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1945
Mailing Address - Country:US
Mailing Address - Phone:732-841-0183
Mailing Address - Fax:
Practice Address - Street 1:67 WALNUT AVE STE 207
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1640
Practice Address - Country:US
Practice Address - Phone:732-982-2888
Practice Address - Fax:732-694-7622
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013416001041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool