MEDICARE: ALEXANDRA ELAINE JONES B.S, A.A.S, L.M.T

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	225700000X	Massage Therapist	33.026607	OH
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1114731742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA ELAINE JONES B.S, A.A.S, L.M.T

Provider Business Mailing Address
First Line	:	3644 ROLLISTON RD # DOWN
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-5137
Country	:	US
Telephone Number	:	216-309-2580
Fax Number	:

Provider Business Practice Location Address
First Line	:	15620 DETROIT AVE STE 106
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-3708
Country	:	US
Telephone Number	:	216-309-2580
Fax Number	:

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

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	10/10/2025

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