Healthcare Provider Details

I. General information

NPI: 1184408171
Provider Name (Legal Business Name): SAMYA JONES ALC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 SLEDGE DR STE B
MOBILE AL
36606-3000
US

IV. Provider business mailing address

1340 SLEDGE DR STE B
MOBILE AL
36606-3000
US

V. Phone/Fax

Practice location:
  • Phone: 251-473-3410
  • Fax: 251-476-4454
Mailing address:
  • Phone: 251-473-3410
  • Fax: 251-476-4454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC05667
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: