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General NPI Number Information
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NPI Number | 1477472884
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Entity Type | Individual
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Provider Name | NELVIN JONES THYME LCADC
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Gender | Male
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Dates
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Enumeration Date | 07/11/2026
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Last Update Date | 07/11/2026
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Provider Practice Location Address
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Address Line | 155 VERONA AVE APT 1A
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City | NEWARK
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State | NJ
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Zip | 07104-4774
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Country | US
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Telephone | 850-851-3721
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Fax |
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Provider Business Mailing Address
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Address Line | 155 VERONA AVE APT 1A
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City | NEWARK
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State | NJ
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Zip | 07104-4774
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Country | US
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Telephone | 850-851-3721
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 37LC00421800
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License Number State | NJ
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