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General NPI Number Information
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NPI Number | 1215237607
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Entity Type | Individual
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Provider Name | SEAN B JONES LPC
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Gender | Male
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 2607 N GRANDVIEW BLVD STE 160G
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City | WAUKESHA
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State | WI
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Zip | 53188-1686
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Country | US
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Telephone | 262-290-3337
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Fax |
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Provider Business Mailing Address
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Address Line | W288S3848 WERN FARM CIR E
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City | WAUKESHA
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State | WI
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Zip | 53189-8919
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Country | US
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Telephone | 145-730-2004
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12639-131
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2996125
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2996-125
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License Number State | WI
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