Fred Jones, CADCIII, LPC
Counselor, Professional in Milwaukee, WI. Individual provider (NPI-1).
NPI number1194806331
StatusActive
Last updated in NPPESAug 3, 2018
Details
- NPI
- 1194806331
- Entity type
- Individual (NPI-1)
- Name
- Fred Jones
- Credential
- CADCIII, LPC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 17, 2006
- Last updated
- Aug 3, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 3220-125 | WI | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 151 | WI |
Practice location
5303 W North AveMilwaukee, WI 53208
Phone 414-445-0997 · Fax 414-445-0989
Mailing address
5303 W North AveMilwaukee, WI 53208-1021
Phone 414-445-0997 · Fax 414-445-0989
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