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NPI Code Detail

MEDICARE: SHANA CORRINE JONES LGPC

MEDICARE:   SHANA CORRINE JONES  LGPC
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 Counselor

General Provider Information

NPI Number : 1336709856
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANA CORRINE JONES LGPC
Provider Business Mailing Address
First Line : 703 TULIP CT
Second Line :
City : EDGEWOOD
State : MD
Zip : 21040-2426
Country : US
Telephone Number : 443-655-6227
Fax Number :
Provider Business Practice Location Address
First Line : 3454 ELLICOTT CENTER DR STE 106
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-4130
Country : US
Telephone Number : 443-655-6227
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2019
Last Update Date : 06/17/2019

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Directions to “ SHANA CORRINE JONES LGPC” Practice Location

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