MEDICARE: KELLI J. JONES LCSW

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	1041C0700X	Clinical Social Worker	34009551A	IN
2	101YM0800X	Mental Health Counselor	33006367A	IN

General Provider Information

NPI Number	:	1548855687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI J. JONES LCSW

Provider Business Mailing Address
First Line	:	5384 RIPPLINGBROOK WAY
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46033-9188
Country	:	US
Telephone Number	:	317-440-6341
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 PINE MEADOW DR
Second Line	:
City	:	BROWNSBURG
State	:	IN
Zip	:	46112-8354
Country	:	US
Telephone Number	:	317-210-0146
Fax Number	:

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

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	08/16/2023

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