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1144710773 NPI number — STACY NICOLE JONES MSW

NPI Number: 1144710773
Health Care Provider/Practitioner: STACY NICOLE JONES MSW

Information about “1144710773” NPI (STACY NICOLE JONES MSW) exists in 1144710773 in HTML format HTML  |  1144710773 in plain Text format TXT  |  1144710773 in PDF (Portable Document Format) PDF  |  1144710773 in an XML format XML  formats.

NPI Number : 1144710773 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144710773",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JONES",
    "FirstName": "STACY",
    "MiddleName": "NICOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SHARON",
    "OtherFirstName": "STACY",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MSW",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1100 TORREY RD STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FENTON",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48430-3327",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "810-494-7180",
    "MailingAddressFaxNumber": "810-215-1334",
    "FirstLinePracticeLocationAddress": "1701 LAKE LANSING RD STE 120",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LANSING",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48912-3798",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "810-494-7180",
    "PracticeLocationAddressFaxNumber": "810-215-1334",
    "EnumerationDate": "05/18/2018",
    "LastUpdateDate": "12/21/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "6801102852",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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