Provider Demographics
NPI:1891184008
Name:JONES, TANYA N (LCSW, PHD)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1121 KEAUNUI DR STE 108
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6365
Mailing Address - Country:US
Mailing Address - Phone:808-551-2228
Mailing Address - Fax:808-433-1551
Practice Address - Street 1:500 WESTOVER DR #13619
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5001
Practice Address - Country:US
Practice Address - Phone:323-205-7088
Practice Address - Fax:833-419-0181
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
HI3087-24NR101YA0400X
HI48011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)