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Kenyetta D. Mcintosh-Jones

Social Worker

Behavioral Health & Social Service Providers

1030 Jefferson Ave, Memphis, TN 38104-2127

PECOS Enrollment

Based on the most recent information from CMS, provider Kenyetta D. Mcintosh-Jones does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1003139635
Provider Type
Individual
Full Name
Mcintosh-Jones, Kenyetta D.
Title
Mrs.
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
3/10/2010
Last Updated
3/10/2010

Contact Information

Practice Location

1030 Jefferson Ave, Memphis, TN 38104-2127

(901) 523-8990

Unlisted Fax

Mailing Location

2736 Greenmill Dr, Memphis, TN 38119-8304

(901) 375-0918

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 5147 Tennessee
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 2446-C Arkansas
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 149013440 Illinois

Kenyetta D. Mcintosh-Jones

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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