Provider Demographics
NPI:1487077400
Name:JONES, JILL BACKMAN (LCSW)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:BACKMAN
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:BACKMAN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:404 E 1700 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-1732
Mailing Address - Country:US
Mailing Address - Phone:801-486-4065
Mailing Address - Fax:
Practice Address - Street 1:404 E 1700 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-1732
Practice Address - Country:US
Practice Address - Phone:801-486-4065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT136423-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical