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NPI Code Detail

MEDICARE: MR. THOMAS DAVID JONES JR. MSW, LCSW

MEDICARE: MR. THOMAS DAVID JONES JR. MSW, 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 Worker18256FL

General Provider Information

NPI Number : 1245814375
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS DAVID JONES JR. MSW, LCSW
Provider Business Mailing Address
First Line : 695 VERBENIA DR
Second Line :
City : SATELLITE BEACH
State : FL
Zip : 32937-2545
Country : US
Telephone Number : 270-875-7401
Fax Number :
Provider Business Practice Location Address
First Line : 200 S HARBOR CITY BLVD STE 401
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-1389
Country : US
Telephone Number : 321-312-0706
Fax Number : 321-779-7729
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2021
Last Update Date : 05/05/2021

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