MEDICARE: MS. URSULA MARIE JONES MSW

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	R026446	NY

General Provider Information

NPI Number	:	1245274174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. URSULA MARIE JONES MSW

Provider Business Mailing Address
First Line	:	5 CLUB RD # 2
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12903-3903
Country	:	US
Telephone Number	:	518-324-4344
Fax Number	:	518-324-4344

Provider Business Practice Location Address
First Line	:	5 CLUB RD # 2
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12903-3903
Country	:	US
Telephone Number	:	518-324-4344
Fax Number	:	518-324-4344

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	03/17/2015

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