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NPI Code Detail

MEDICARE: IESHA JONES BSW LSW

MEDICARE: IESHA JONES BSW LSW
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
11041C0700XClinical Social WorkerS1601289OH
21041C0700XClinical Social Worker106103TX

General Provider Information

NPI Number : 1275062077
Entity Type Code : Individual
Provider Name (Legal Business Name) : IESHA JONES BSW LSW
Provider Business Mailing Address
First Line : 1011 COLLEGE AVE
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-3307
Country : US
Telephone Number : 903-920-7781
Fax Number :
Provider Business Practice Location Address
First Line : 1011 COLLEGE AVE
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-3307
Country : US
Telephone Number : 903-589-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2017
Last Update Date : 01/26/2024

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Directions to “ IESHA JONES BSW LSW” Practice Location

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