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General NPI Number Information
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NPI Number | 1982881017
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Entity Type | Individual
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Provider Name | KIA SHAVEEN JONES-MASTIN LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 3115 MACKINAW ST
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City | SAGINAW
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State | MI
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Zip | 48602-3221
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Country | US
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Telephone | 989-399-5940
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Fax | 989-399-8261
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Provider Business Mailing Address
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Address Line | 501 LAPEER AVE
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City | SAGINAW
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State | MI
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Zip | 48607-1203
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Country | US
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Telephone | 989-759-6464
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Fax | 989-399-8233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801106546
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801089366
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License Number State | MI
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