Healthcare Provider Details

I. General information

NPI: 1689786667
Provider Name (Legal Business Name): SHELLEY YOUNG JONES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. SHELLEY LYNN YOUNG

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 COLLEGE ST
COLUMBUS MS
39701-5772
US

IV. Provider business mailing address

1100 7TH AVENUE
JASPER AL
35501
US

V. Phone/Fax

Practice location:
  • Phone: 662-584-5097
  • Fax: 662-495-4079
Mailing address:
  • Phone: 205-302-9000
  • Fax: 205-387-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC9964
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1797G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: