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NPI Code Detail

MEDICARE: KRISTIN JONES

MEDICARE:   KRISTIN  JONES
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
1101YM0800XMental Health CounselorA15078NC
2101YP2500XProfessional CounselorA15078NC

General Provider Information

NPI Number : 1225685951
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN JONES
Provider Business Mailing Address
First Line : 3117 GENLEE DR
Second Line :
City : DURHAM
State : NC
Zip : 27704-1884
Country : US
Telephone Number : 910-988-5902
Fax Number : 919-572-8833
Provider Business Practice Location Address
First Line : 2402 S MIAMI BLVD STE 108
Second Line :
City : DURHAM
State : NC
Zip : 27703-4928
Country : US
Telephone Number : 910-988-5902
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2019
Last Update Date : 09/10/2019

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Directions to “ KRISTIN JONES ” Practice Location

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