Healthcare Provider Details

I. General information

NPI: 1437545860
Provider Name (Legal Business Name): EMILY ROSE MCJONES MA, LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 N SYCAMORE ST
LANSING MI
48933-1096
US

IV. Provider business mailing address

320 N SYCAMORE ST
LANSING MI
48933-1096
US

V. Phone/Fax

Practice location:
  • Phone: 517-325-9594
  • Fax:
Mailing address:
  • Phone: 517-325-9594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301015981
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: