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NPI Code Detail

MEDICARE: SHIMETRA JONES LCSW

MEDICARE: SHIMETRA JONES LCSW
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
11041C0700XClinical Social Worker103558TX

General Provider Information

NPI Number : 1164121430
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIMETRA JONES LCSW
Provider Business Mailing Address
First Line : 2136 SARA JANE PKWY APT 8151
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75052-4942
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 405 AIRPORT FWY STE 2
Second Line :
City : BEDFORD
State : TX
Zip : 76021-5334
Country : US
Telephone Number : 682-445-0431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2023
Last Update Date : 03/06/2023

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Directions to “ SHIMETRA JONES LCSW” Practice Location

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