MEDICARE: TJRILMEL JONES SR. LCSWA

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	1041C0700X	Clinical Social Worker	P020281	NC

General Provider Information

NPI Number	:	1235997743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TJRILMEL JONES SR. LCSWA

Provider Business Mailing Address
First Line	:	718 CHESWICK AVE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-7079
Country	:	US
Telephone Number	:	980-354-1199
Fax Number	:

Provider Business Practice Location Address
First Line	:	5601 EXECUTIVE CENTER DR STE 200
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-8841
Country	:	US
Telephone Number	:	704-537-1022
Fax Number	:

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

Provider Enumeration Date	:	03/08/2024
Last Update Date	:	03/08/2024

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