Provider Demographics
NPI:1316319478
Name:JONES, LATIRA (BSW)
Entity type:Individual
Prefix:MS
First Name:LATIRA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 EE WALLACE BLVD S
Mailing Address - Street 2:
Mailing Address - City:FERRIDAY
Mailing Address - State:LA
Mailing Address - Zip Code:71334-3224
Mailing Address - Country:US
Mailing Address - Phone:318-757-9363
Mailing Address - Fax:
Practice Address - Street 1:1644 B CARTER ST. SUITE 2
Practice Address - Street 2:
Practice Address - City:VIDAILA
Practice Address - State:LA
Practice Address - Zip Code:71373
Practice Address - Country:US
Practice Address - Phone:131-841-4306
Practice Address - Fax:131-841-4306
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health