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General NPI Number Information
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NPI Number | 1306978648
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Entity Type | Individual
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Provider Name | MS. BERNADETTE MARIE JONES
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6224 PORTSMOUTH BLVD SUITE 102
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City | PORTSMOUTH
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State | VA
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Zip | 23701-1345
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Country | US
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Telephone | 757-686-9028
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Fax |
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Provider Business Mailing Address
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Address Line | 627 NANSEMOND ST
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City | PORTSMOUTH
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State | VA
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Zip | 23707-1111
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Country | US
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Telephone | 757-399-4267
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904000482
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License Number State | VA
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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 | I-2664
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 991139
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License Number State | CO
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