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General NPI Number Information
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NPI Number | 1588145593
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Entity Type | Organization
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Legal Business Name | GISELLE L JONES, LICENSED CLINICAL SOCIAL WORKER, INC
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 1741 SILVER LAKE BLVD STE 2A
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City | LOS ANGELES
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State | CA
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Zip | 90026
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Country | US
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Telephone | 917-517-7347
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 FAIR OAKS AVE # 9
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-3311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GISELLE L JONES
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Credential | LCSW
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Telephone | 323-686-1778
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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 | 77482
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License Number State | CA
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