MEDICARE: JORDAN JANELLE-YVONNE JONES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225C00000X	Rehabilitation Counselor
2	225CX0006X	Orientation and Mobility Training Rehabilitation Counselor
3	261QR0400X	Rehabilitation Clinic/Center
4	103TE1100X	Exercise & Sports Psychologist
5	1744R1103X	Research Study Abstracter/Coder
6	224Y00000X	Clinical Exercise Physiologist
7	225400000X	Rehabilitation Practitioner
8	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)
9	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
10	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
11	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1972098366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN JANELLE-YVONNE JONES

Provider Business Mailing Address
First Line	:	1451 LINN LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-1703
Country	:	US
Telephone Number	:	702-901-9709
Fax Number	:

Provider Business Practice Location Address
First Line	:	4794 S EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119
Country	:	US
Telephone Number	:	702-751-4801
Fax Number	:

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

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	06/28/2018

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