MEDICARE: JENNIFER KELLY JONES LPC, MS

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	101Y00000X	Counselor	3145-125	WI

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	:	1134147952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER KELLY JONES LPC, MS

Provider Business Mailing Address
First Line	:	2301 SUN VALLEY DR
Second Line	:	SUITE #209
City	:	DELAFIELD
State	:	WI
Zip	:	53018-2318
Country	:	US
Telephone Number	:	262-646-8288
Fax Number	:	262-646-8255

Provider Business Practice Location Address
First Line	:	2301 SUN VALLEY DR
Second Line	:	SUITE #209
City	:	DELAFIELD
State	:	WI
Zip	:	53018-2318
Country	:	US
Telephone Number	:	262-646-8288
Fax Number	:	262-646-8255

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	01/21/2010

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