MEDICARE: MS. REGINA MARLO 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1710302781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REGINA MARLO JONES

Provider Business Mailing Address
First Line	:	521 YOPP RD STE 214312
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-3595
Country	:	US
Telephone Number	:	910-939-8144
Fax Number	:	910-500-0931

Provider Business Practice Location Address
First Line	:	521 YOPP RD STE 214312
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-3595
Country	:	US
Telephone Number	:	910-939-8144
Fax Number	:	910-500-0931

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

Provider Enumeration Date	:	02/26/2014
Last Update Date	:	03/18/2026

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