1427723956 NPI number — MRS. KIMBERLY LYNN JONES-CARR LLMFT

Table of content: MRS. KIMBERLY LYNN JONES-CARR LLMFT (NPI 1427723956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427723956 NPI number — MRS. KIMBERLY LYNN JONES-CARR LLMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES-CARR
Provider First Name:
KIMBERLY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LLMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES-CARR
Provider Other First Name:
KIMBERLY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
KIMBERLY LYNN JONES
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427723956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3126 WILLIAMSBURG RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48108-2074
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-223-2571
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TROY MEICAL PLAZA, 1777 AXTEL DR. #100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48084
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-787-3831
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2021

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: 106H00000X , with the licence number:  4151001021 , 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)