MEDICARE: LARRY WAYNE JONES JR. LPC, M. DIV

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	101YP2500X	Professional Counselor	LPC.0017371	CO

General Provider Information

NPI Number	:	1851151021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY WAYNE JONES JR. LPC, M. DIV

Provider Business Mailing Address
First Line	:	PSC 80 BOX 13287
Second Line	:
City	:	APO
State	:	AP
Zip	:	96367-0035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLDG 439
Second Line	:	CAMP FOSTER MARINE CORPS BASE
City	:	KITAMAE
State	:	CHATAN-CHO OKINAWA
Zip	:	9040117
Country	:	JP
Telephone Number	:	315-645-5548
Fax Number	:

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

Provider Enumeration Date	:	03/22/2024
Last Update Date	:	03/22/2024

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