MEDICARE: MRS. NETTIE LOUISE JONES 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
1	101YP2500X	Professional Counselor	18976	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063621050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NETTIE LOUISE JONES LPC

Provider Business Mailing Address
First Line	:	4127 WORRELL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-3219
Country	:	US
Telephone Number	:	832-452-8863
Fax Number	:	713-630-0821

Provider Business Practice Location Address
First Line	:	4127 WORRELL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-3219
Country	:	US
Telephone Number	:	832-452-8863
Fax Number	:	713-630-0821

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/09/2007

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