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NPI Code Detail

MEDICARE: MS. PAMELA LINDA JONES

MEDICARE: MS. PAMELA LINDA JONES
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2172V00000XCommunity Health Worker142899733MI
3175T00000XPeer SpecialistMI

General Provider Information

NPI Number : 1417115833
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAMELA LINDA JONES
Provider Business Mailing Address
First Line : 8804 TRAVERSE ST
Second Line :
City : DETROIT
State : MI
Zip : 48213-1194
Country : US
Telephone Number : 313-415-8859
Fax Number :
Provider Business Practice Location Address
First Line : 6451 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2212
Country : US
Telephone Number : 313-203-1661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2008
Last Update Date : 07/14/2025

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Directions to “ MS. PAMELA LINDA JONES ” Practice Location

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