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NPI Code Detail

MEDICARE: MISS SEBRINA JONES LCSW-R

MEDICARE: MISS SEBRINA JONES LCSW-R
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
1104100000XSocial Worker076512NY
21041C0700XClinical Social Worker080542NY
31041C0700XClinical Social Worker14328SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080542OTHERNYLICENSE NUMBER ISSUED BY NEW YORK STATE
214328OTHERSCLISW-CP

General Provider Information

NPI Number : 1639401979
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SEBRINA JONES LCSW-R
Provider Business Mailing Address
First Line : PO BOX 748465
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8465
Country : US
Telephone Number : 855-284-7483
Fax Number :
Provider Business Practice Location Address
First Line : 4975 LACROSS RD STE 351
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-6530
Country : US
Telephone Number : 855-284-7483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2010
Last Update Date : 08/07/2023

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