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General NPI Number Information
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NPI Number | 1770591091
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Entity Type | Individual
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Provider Name | JAMES MADISON JONES L.I.S.W.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 BARBARA LOOP SE SUITE I
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City | RIO RANCHO
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State | NM
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Zip | 87124-1088
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Country | US
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Telephone | 505-321-5444
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Fax | 505-890-5652
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Provider Business Mailing Address
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Address Line | PO BOX 2264
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City | CORRALES
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State | NM
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Zip | 87048-2264
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Country | US
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Telephone | 505-321-5444
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Fax | 505-890-5652
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | I-1922
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License Number State | NM
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