Healthcare Provider Details

I. General information

NPI: 1609433283
Provider Name (Legal Business Name): STACEY JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WEISS ST
SAGINAW MI
48602-5251
US

IV. Provider business mailing address

1500 WEISS ST
SAGINAW MI
48602-5251
US

V. Phone/Fax

Practice location:
  • Phone: 989-392-2533
  • Fax: 517-546-1300
Mailing address:
  • Phone: 989-392-2533
  • Fax: 517-546-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: