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NPI Code Detail

MEDICARE: MRS. LISA MCDADE JONES MSP, CCC-SLP

MEDICARE: MRS. LISA MCDADE JONES MSP, CCC-SLP
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
1235Z00000XSpeech-Language Pathologist1040SC

General Provider Information

NPI Number : 1861671430
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA MCDADE JONES MSP, CCC-SLP
Provider Business Mailing Address
First Line : 75 CALHOUN ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29401-3538
Country : US
Telephone Number : 843-849-2838
Fax Number : 843-849-2884
Provider Business Practice Location Address
First Line : 75 CALHOUN ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29401-3538
Country : US
Telephone Number : 843-849-2838
Fax Number : 843-849-2884
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2007
Last Update Date : 09/07/2014

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