Provider Demographics
NPI:1427138007
Name:JONES, ALFRED JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:
Last Name:JONES
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PLEASANT HOME RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-3518
Mailing Address - Country:US
Mailing Address - Phone:706-364-3209
Mailing Address - Fax:706-364-3259
Practice Address - Street 1:114 PLEASANT HOME RD
Practice Address - Street 2:SUITE A
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-3518
Practice Address - Country:US
Practice Address - Phone:706-364-3209
Practice Address - Fax:706-364-3259
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0024041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA455283353AMedicaid
GA030496408OtherTAX ID
GA90301OtherSAP
GA455283353AMedicaid