Provider Demographics
NPI:1679986244
Name:JONES, BERNETTE KELLEY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BERNETTE
Middle Name:KELLEY
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 PENNY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8122
Mailing Address - Country:US
Mailing Address - Phone:336-812-9733
Mailing Address - Fax:336-812-9374
Practice Address - Street 1:2411 PENNY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8122
Practice Address - Country:US
Practice Address - Phone:336-812-9733
Practice Address - Fax:336-500-8920
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0100411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical