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NPI Code Detail

MEDICARE: JEANINE JONES LCSW

MEDICARE:   JEANINE  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
11041C0700XClinical Social Worker34000698ASD

General Provider Information

NPI Number : 1598922098
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANINE JONES LCSW
Provider Business Mailing Address
First Line : PO BOX 55107
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-0107
Country : US
Telephone Number : 317-253-7387
Fax Number : 317-253-7388
Provider Business Practice Location Address
First Line : 3016 LAKE SHORE DR UNIT E
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-2324
Country : US
Telephone Number : 317-253-7387
Fax Number : 317-253-7388
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2008
Last Update Date : 05/21/2008

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Directions to “ JEANINE JONES LCSW” Practice Location

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