Basic Information
| Provider Information | |||||||||
| NPI: | 1164480919 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | MARGARET | ||||||||
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| Credential: | CSW | ||||||||
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| OtherLastName: | JONES | ||||||||
| OtherFirstName: | PEG | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 812 E JOLLY RD | ||||||||
| Address2: | STE 210 | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489106818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173468410 | ||||||||
| FaxNumber: | 5173468291 | ||||||||
| Practice Location | |||||||||
| Address1: | 5303 S CEDAR ST | ||||||||
| Address2: | STE 106 | ||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489113800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173468071 | ||||||||
| FaxNumber: | 5173468291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801005805 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.