Healthcare Provider Details

I. General information

NPI: 1740111889
Provider Name (Legal Business Name): TINKER MAYA JONES MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 GRAND AVE
SAINT PAUL MN
55105-2885
US

IV. Provider business mailing address

1123 GRAND AVE
SAINT PAUL MN
55105-2885
US

V. Phone/Fax

Practice location:
  • Phone: 612-424-2466
  • Fax: 612-677-3146
Mailing address:
  • Phone: 612-424-2466
  • Fax: 612-677-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32458
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: