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NPI Code Detail

MEDICARE: REGINALD LAMAR JONES LMHC

MEDICARE: REGINALD LAMAR JONES LMHC
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 CounselorMH13533FL

General Provider Information

NPI Number : 1356962567
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINALD LAMAR JONES LMHC
Provider Business Mailing Address
First Line : 2828 BAKER AVE
Second Line :
City : MARIANNA
State : FL
Zip : 32448-4304
Country : US
Telephone Number : 850-482-8635
Fax Number :
Provider Business Practice Location Address
First Line : 362 HIGHWAY 83 N
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32433-3800
Country : US
Telephone Number : 850-892-8015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2020
Last Update Date : 04/28/2020

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