MEDICARE: MR. DEANGELO LACLARENCE JELKS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1346442548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DEANGELO LACLARENCE JELKS

Provider Business Mailing Address
First Line	:	3623 FOUNTAIN AVE
Second Line	:	APARTMENT 73
City	:	EAST RIDGE
State	:	TN
Zip	:	37412-1846
Country	:	US
Telephone Number	:	423-954-8860
Fax Number	:

Provider Business Practice Location Address
First Line	:	3623 FOUNTAIN AVE
Second Line	:	APARTMENT 73
City	:	EAST RIDGE
State	:	TN
Zip	:	37412-1846
Country	:	US
Telephone Number	:	423-954-8860
Fax Number	:

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

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1437639929 — BRITTANY CHWASTIAK
Practice Location Address:

25921 RIDGE RD
DAMASCUS, MD
20872-1846

Practice Phone: 215-804-5713
Practice Fax:

1548721954 — MRS. LORI RECORD MS CCC-SLP
Practice Location Address:

25921 RIDGE RD
DAMASCUS, MD
20872-1846

Practice Phone: 240-207-2400
Practice Fax:

1619430204 — MRS. DANA LANN SCHNEPF
Practice Location Address:

1846 GLEN RIDGE RD
TOWSON, MD
21286-8914

Practice Phone: 410-207-4794
Practice Fax:

1497643498 — WE R THERE HOMECARE LLC
Practice Location Address:

3347 HEATHER RIDGE DR APT 204
INDIANAPOLIS, IN
46214-1846

Practice Phone: 317-252-3525
Practice Fax: 317-252-3525

1174521371 — NICHOLAS DROBNY OD
Practice Location Address:

301 EAST ST
BLOOMSBURG, PA
17815-1846

Practice Phone: 570-387-8800
Practice Fax: 570-784-8887

1417955600 — DR. LAURIE COSTARELLI OD
Practice Location Address:

301 EAST ST
BLOOMSBURG, PA
17815-1846

Practice Phone: 570-387-8800
Practice Fax: 570-784-8887

Directions to “ MR. DEANGELO LACLARENCE JELKS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.