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NPI Code Detail

MEDICARE: STACEY JONES MED, LPC, LCDC

MEDICARE: STACEY JONES MED, LPC, LCDC
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 Counselor86231TX
2101YA0400XAddiction (Substance Use Disorder) Counselor15670TX

General Provider Information

NPI Number : 1831767342
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY JONES MED, LPC, LCDC
Provider Business Mailing Address
First Line : 2201 DOTTIE LYNN PKWY STE 127
Second Line :
City : FORT WORTH
State : TX
Zip : 76120-4435
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3740 N JOSEY LN STE 145
Second Line :
City : CARROLLTON
State : TX
Zip : 75007-2471
Country : US
Telephone Number : 469-208-2406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2021
Last Update Date : 01/21/2023

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