MEDICARE: MS. KIT JONES LPC

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	101YP2500X	Professional Counselor	15337	TX

General Provider Information

NPI Number	:	1518944412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIT JONES LPC

Provider Business Mailing Address
First Line	:	2308 RYAN PLACE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-2545
Country	:	US
Telephone Number	:	817-921-0433
Fax Number	:	817-921-0533

Provider Business Practice Location Address
First Line	:	2308 RYAN PLACE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-2545
Country	:	US
Telephone Number	:	817-921-0433
Fax Number	:	817-921-0533

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

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	07/08/2007

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