Provider Demographics
NPI:1316482763
Name:JONES-AWOLUSI, TANYA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ANN
Last Name:JONES-AWOLUSI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:ANN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1000 STATE ROUTE 34 STE 301
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3485
Mailing Address - Country:US
Mailing Address - Phone:732-858-1533
Mailing Address - Fax:
Practice Address - Street 1:1000 STATE ROUTE 34 STE 301
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3485
Practice Address - Country:US
Practice Address - Phone:732-858-1533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056861001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical