Basic Information
Provider Information
NPI: 1265590178
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: BARBARA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: LCSW-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
Address2: 2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018162424
FaxNumber:  
Practice Location
Address1: 1221 MERCANTILE LN
Address2:  
City: LARGO
State: MD
PostalCode: 207745374
CountryCode: US
TelephoneNumber: 3016185985
FaxNumber: 3016185909
Other Information
ProviderEnumerationDate: 12/04/2006
LastUpdateDate: 06/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000XLC302158DCN Behavioral Health & Social Service ProvidersPsychologist 
103T00000X10336MDY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


Home