MEDICARE: DEBORAH SUE 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	0904011423	VA

General Provider Information

NPI Number	:	1598305229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH SUE JONES LCSW

Provider Business Mailing Address
First Line	:	3575 BRIDGE RD STE 8
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23435-1800
Country	:	US
Telephone Number	:	757-739-5037
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 CEDAR RD STE 2C
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-5527
Country	:	US
Telephone Number	:	757-739-5037
Fax Number	:

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

Provider Enumeration Date	:	01/10/2020
Last Update Date	:	01/10/2020

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