Provider Demographics
NPI:1528800604
Name:JONES, CLARISSA RENEE (MSW, LISW, CDCA)
Entity type:Individual
Prefix:MRS
First Name:CLARISSA
Middle Name:RENEE
Last Name:JONES
Suffix:
Gender:F
Credentials:MSW, LISW, CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 S MILLER RD STE LL2
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4170
Mailing Address - Country:US
Mailing Address - Phone:330-836-8370
Mailing Address - Fax:330-836-8373
Practice Address - Street 1:55 S MILLER RD STE LL2
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4170
Practice Address - Country:US
Practice Address - Phone:330-836-8370
Practice Address - Fax:330-836-8373
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.24052511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical