MEDICARE: MS. SIMONE A JONES

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	251S00000X	Community/Behavioral Health Agency
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1952533911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SIMONE A JONES

Provider Business Mailing Address
First Line	:	8228 HEATHER ROCK CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7631
Country	:	US
Telephone Number	:	702-480-5312
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 W CHARLESTON BLVD STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1067
Country	:	US
Telephone Number	:	702-437-4673
Fax Number	:

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

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	03/19/2020

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