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NPI Code Detail

MEDICARE: CHANTEL JONES LCPC,NCC

MEDICARE:   CHANTEL  JONES  LCPC,NCC
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
1101YM0800XMental Health CounselorLCPC-2816ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000010139165OTHERIDBLUE SHIELD
2Q3444OTHERIDBLUE CROSS
32256615OTHERIDCIGNA

General Provider Information

NPI Number : 1215096474
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTEL JONES LCPC,NCC
Provider Business Mailing Address
First Line : 1414 W FRANKLIN ST
Second Line :
City : BOISE
State : ID
Zip : 83702-5023
Country : US
Telephone Number : 208-375-0167
Fax Number : 208-395-1948
Provider Business Practice Location Address
First Line : 1414 W FRANKLIN ST
Second Line :
City : BOISE
State : ID
Zip : 83702-5023
Country : US
Telephone Number : 208-375-0167
Fax Number : 208-395-1948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 07/08/2007

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Directions to “ CHANTEL JONES LCPC,NCC” Practice Location

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