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General NPI Number Information
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NPI Number | 1174134803
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Entity Type | Individual
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Provider Name | JERMIAH JONOAH JONES
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Gender | Male
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 307 E 54TH ST 3
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City | BROOKLYN
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State | NY
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Zip | 11203
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Country | US
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Telephone | 917-353-3082
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Fax |
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Provider Business Mailing Address
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Address Line | 307 E 54TH ST
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City | BROOKLYN
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State | NY
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Zip | 11203-4612
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Country | US
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Telephone | 347-543-5589
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 109376
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 099708
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License Number State | NY
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