MEDICARE: MR. CHAD ERIC JONES M.S.

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	2435	KS
2	101YP2500X	Professional Counselor	2010012499	MO

General Provider Information

NPI Number	:	1982680856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD ERIC JONES M.S.

Provider Business Mailing Address
First Line	:	16 WILLOW LAKE DR
Second Line	:
City	:	LINDSBORG
State	:	KS
Zip	:	67456-5159
Country	:	US
Telephone Number	:	785-577-0748
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 WILLOW LAKE DR
Second Line	:
City	:	LINDSBORG
State	:	KS
Zip	:	67456-5159
Country	:	US
Telephone Number	:	785-577-0748
Fax Number	:

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	03/04/2016

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