MEDICARE: LAKYRIA KAMYRA 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
1	101YP2500X	Professional Counselor	100618	TX

General Provider Information

NPI Number	:	1609744374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKYRIA KAMYRA JONES

Provider Business Mailing Address
First Line	:	9616 CHECOTA DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75217-3003
Country	:	US
Telephone Number	:	469-805-7850
Fax Number	:

Provider Business Practice Location Address
First Line	:	4347 S HAMPTON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-1065
Country	:	US
Telephone Number	:	469-527-3080
Fax Number	:

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

Provider Enumeration Date	:	10/24/2025
Last Update Date	:	10/24/2025

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