MEDICARE: HALEY ELISE JONES LCSWA

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	1041C0700X	Clinical Social Worker	P022106	NC

General Provider Information

NPI Number	:	1699638551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY ELISE JONES LCSWA

Provider Business Mailing Address
First Line	:	524 KENNET CT
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29301-5377
Country	:	US
Telephone Number	:	864-357-8578
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 1/2 PRINCESS ST
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-3951
Country	:	US
Telephone Number	:	910-202-4326
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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