Healthcare Provider Details

I. General information

NPI: 1003727827
Provider Name (Legal Business Name): KATIE LEORA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 E MICHIGAN AVE # 440
KALAMAZOO MI
49007-6400
US

IV. Provider business mailing address

229 E MICHIGAN AVE STE 440
KALAMAZOO MI
49007-6400
US

V. Phone/Fax

Practice location:
  • Phone: 269-254-6613
  • Fax:
Mailing address:
  • Phone: 269-254-6613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121620
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: