Vernard R Jones, LCMHT,CCAP,MAC,ICADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Tupelo, MS

NPI 1730280397 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1730280397
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
502094 (MS)
Practice address
920 Boone St
Tupelo, MS 38804-5908
Phone
(662) 844-3531
Fax
(662) 844-1757
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
00-0075MSMDAddiction (Substance Use Disorder) Counselor
502094MSMDAddiction (Substance Use Disorder) Counselor
LH0602MSMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00-0075 MS
Addiction (Substance Use Disorder) Counselor 101YA0400X LH0602 MS
Addiction (Substance Use Disorder) Counselor 101YA0400X 502094 MS Yes

Addresses

Primary practice location

920 Boone St
Tupelo, MS 38804-5908

Mailing address

814 Walnut St
Amory, MS 38821-3639
Phone (662) 253-5085

Other providers in Tupelo, MS

All providers in Tupelo, MS · Addiction (Substance Use Disorder) Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.