Provider Demographics
NPI:1699158972
Name:JONES, MELISSA JANE (PHD, MSW)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:JANE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 E ROGER RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8563
Mailing Address - Country:US
Mailing Address - Phone:707-474-3130
Mailing Address - Fax:
Practice Address - Street 1:2948 E 8TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-5248
Practice Address - Country:US
Practice Address - Phone:520-261-9556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-03
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW66919104100000X
CALCSW863681041C0700X
CA1702167861041S0200X
AZLCSW-185901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool