MEDICARE: MR. JOHN PAUL JONES LCPC - 9219 (ID)

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	101YM0800X	Mental Health Counselor	LCMHC-13656427-6004	UT
2	101YM0800X	Mental Health Counselor	LCPC-9219	ID

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	:	1326499120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN PAUL JONES LCPC - 9219 (ID)

Provider Business Mailing Address
First Line	:	280 E 5TH N STE 280
Second Line	:
City	:	MOUNTAIN HOME
State	:	ID
Zip	:	83647-2749
Country	:	US
Telephone Number	:	208-580-8525
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 E 5TH N STE 280
Second Line	:
City	:	MOUNTAIN HOME
State	:	ID
Zip	:	83647-2749
Country	:	US
Telephone Number	:	208-591-0760
Fax Number	:

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

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	07/31/2024

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