MEDICARE: MS. MICHELE JONES DIAL LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	75397	TX

General Provider Information

NPI Number	:	1003215443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE JONES DIAL LPC

Provider Business Mailing Address
First Line	:	611 W 22ND ST STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1968
Country	:	US
Telephone Number	:	713-380-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	611 W 22ND ST STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1968
Country	:	US
Telephone Number	:	713-380-1151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	12/13/2023

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