Provider Demographics
NPI:1568295764
Name:JONES, KENNA NATALIE (LCSW)
Entity type:Individual
Prefix:
First Name:KENNA
Middle Name:NATALIE
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KENNA
Other - Middle Name:NATALIE
Other - Last Name:JONES-SHANKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1 MELROSE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5556
Mailing Address - Country:US
Mailing Address - Phone:530-559-4032
Mailing Address - Fax:
Practice Address - Street 1:185 DEVONSHIRE ST STE 801&802
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1407
Practice Address - Country:US
Practice Address - Phone:781-551-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2309161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical