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General NPI Number Information
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NPI Number | 1215129002
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Entity Type | Organization
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Legal Business Name | CONNIE L JONES INC
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Dates
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Enumeration Date | 08/15/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 781 COLLEGE STREET
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City | MACON
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State | GA
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Zip | 31201
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Country | US
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Telephone | 478-742-2953
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Fax | 478-742-2953
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Provider Business Mailing Address
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Address Line | 781 COLLEGE STREET
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City | MACON
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State | GA
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Zip | 31201
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Country | US
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Telephone | 478-742-2953
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Fax | 478-742-2953
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | CONNIE L JONES
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Credential | LCSW LMFT
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Telephone | 478-742-2953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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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 |
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License Number State |
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