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General NPI Number Information
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NPI Number | 1609598416
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Entity Type | Individual
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Provider Name | BRANDON JONES CM, COMM, LCSW,PRES,
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Gender | Male
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 51 E 125TH ST
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City | NEW YORK
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State | NY
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Zip | 10035-1685
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Country | US
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Telephone | 212-470-1465
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Fax | 646-921-3189
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Provider Business Mailing Address
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Address Line | 1075 WEBSTER AVE # 4B5
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City | BRONX
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State | NY
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Zip | 10456-5931
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Country | US
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Telephone | 212-470-1465
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Fax | 646-921-3189
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0001135
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License Number State | NY
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