Provider Demographics
NPI:1568608305
Name:TAYLOR-JONES, BERNICE Y (LCADC, LPC, CSW, MHS)
Entity Type:Individual
Prefix:MRS
First Name:BERNICE
Middle Name:Y
Last Name:TAYLOR-JONES
Suffix:
Gender:F
Credentials:LCADC, LPC, CSW, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1902
Mailing Address - Country:US
Mailing Address - Phone:973-580-4277
Mailing Address - Fax:973-678-6742
Practice Address - Street 1:920 BROAD ST # 1114
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2660
Practice Address - Country:US
Practice Address - Phone:973-580-4277
Practice Address - Fax:973-678-6742
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00050000101YA0400X
PAPC005021101YP2500X
NJ44SW00706700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker