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NPI Code Detail

MEDICARE: JUANITA CARMELLA JONES MA, NCC, LPC

MEDICARE: JUANITA CARMELLA JONES MA, NCC, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4578LA
2101YM0800XMental Health Counselor4578LA
3101Y00000XCounselor4578LA

General Provider Information

NPI Number : 1013911775
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUANITA CARMELLA JONES MA, NCC, LPC
Provider Business Mailing Address
First Line : 1310 N HEARNE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-6516
Country : US
Telephone Number : 318-676-5111
Fax Number : 318-676-5945
Provider Business Practice Location Address
First Line : 1310 N HEARNE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-6516
Country : US
Telephone Number : 318-676-5111
Fax Number : 318-676-5945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 10/10/2016

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