MEDICARE: EMILY SHEPHERD JONES LAC, LPCC

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	101YM0800X	Mental Health Counselor	LPCC.0019560	CO
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACD.0002345	CO

General Provider Information

NPI Number	:	1659141885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SHEPHERD JONES LAC, LPCC

Provider Business Mailing Address
First Line	:	1956 LAWRENCE ST APT 614
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-2228
Country	:	US
Telephone Number	:	571-286-1366
Fax Number	:

Provider Business Practice Location Address
First Line	:	1956 LAWRENCE ST APT 614
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-2228
Country	:	US
Telephone Number	:	571-286-1366
Fax Number	:

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

Provider Enumeration Date	:	01/08/2024
Last Update Date	:	01/08/2024

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