MEDICARE: MRS. ANNA TERESA 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
1	1041C0700X	Clinical Social Worker	LCSW-16664	AZ

General Provider Information

NPI Number	:	1306374392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA TERESA JONES LCSW

Provider Business Mailing Address
First Line	:	1261 E VOLTAIRE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4963
Country	:	US
Telephone Number	:	602-703-5807
Fax Number	:

Provider Business Practice Location Address
First Line	:	8751 N 51ST AVE STE 121E
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85302-4941
Country	:	US
Telephone Number	:	602-814-7580
Fax Number	:

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

Provider Enumeration Date	:	06/02/2017
Last Update Date	:	06/02/2017

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