Doctor Name: | RICHARD JONES |
NPI Number: | 1073996807 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCAS, SAP |
License Number: | LCAS-4752 |
Business Practice Address: | 120 Fowler Rd Campobello, SC - 293229115 |
Business Phone Number: | 8647648504 |
Business Fax Number: | |
Mailing Address: | 120 Fowler Rd, CAMPOBELLO |
State: | SC |
Postal Code: | 293229115 |
Phone Number: | 8647648504 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2015 |
NPI Last Update Date: | 06/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LCAS-4752 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |