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NPI Code Detail

MEDICARE: CLARENCE JONES

MEDICARE:   CLARENCE  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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1649700055
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARENCE JONES
Provider Business Mailing Address
First Line : 3600 DEKALB TECHNOLOGY PKWY STE 140
Second Line :
City : ATLANTA
State : GA
Zip : 30340-3617
Country : US
Telephone Number : 404-989-3114
Fax Number : 470-282-5102
Provider Business Practice Location Address
First Line : 3600 DEKALB TECHNOLOGY PKWY
Second Line :
City : ATLANTA
State : GA
Zip : 30340-3612
Country : US
Telephone Number : 404-989-3114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2017
Last Update Date : 08/11/2017

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Directions to “ CLARENCE JONES ” Practice Location

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