MEDICARE: ADRIAN E JONES CSAC, SAP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	11659-132	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134206022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIAN E JONES CSAC, SAP

Provider Business Mailing Address
First Line	:	2008 N DR MARTIN LUTHER KING DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53212-3153
Country	:	US
Telephone Number	:	414-336-1303
Fax Number	:

Provider Business Practice Location Address
First Line	:	6737 W WASHINGTON ST
Second Line	:	2225
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-5647
Country	:	US
Telephone Number	:	414-256-4808
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/05/2014

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