Provider Demographics
NPI:1689786667
Name:JONES, SHELLEY YOUNG (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:YOUNG
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:LYNN
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 7TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501
Mailing Address - Country:US
Mailing Address - Phone:205-302-9000
Mailing Address - Fax:205-387-8270
Practice Address - Street 1:1100 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501
Practice Address - Country:US
Practice Address - Phone:205-302-9000
Practice Address - Fax:205-387-8270
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1797G1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051557482YOUMedicare ID - Type Unspecified
Q67727Medicare UPIN