1386088961 NPI number — DOROTHY JANE JONES MA, LPC, CAADC

Table of content: DOROTHY JANE JONES MA, LPC, CAADC (NPI 1386088961)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386088961 NPI number — DOROTHY JANE JONES MA, LPC, CAADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
DOROTHY
Provider Middle Name:
JANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LPC, CAADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES
Provider Other First Name:
JANE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, LPC, CAADC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1386088961
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30324 WICKLOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48334-4768
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-444-9299
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41700 GARDENBROOK RD STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOVI
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48375-1320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-450-4500
Provider Business Practice Location Address Fax Number:
248-244-1330
Provider Enumeration Date:
04/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  6401012705 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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