Provider Demographics
NPI:1396089470
Name:JONES, BRIAN KEVIN (LCSW, CADC1)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:KEVIN
Last Name:JONES
Suffix:
Gender:M
Credentials:LCSW, CADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 SW 28TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2302
Mailing Address - Country:US
Mailing Address - Phone:785-969-2843
Mailing Address - Fax:
Practice Address - Street 1:5040 SW 28TH ST STE B
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2302
Practice Address - Country:US
Practice Address - Phone:785-969-2843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL68311041C0700X
KS1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR165772Medicaid