Provider Demographics
NPI:1033811294
Name:JONES, ALISSA
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 HIDDEN LAKES DR SE APT 301
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-9011
Mailing Address - Country:US
Mailing Address - Phone:989-590-2188
Mailing Address - Fax:
Practice Address - Street 1:947 DONOVAN ST
Practice Address - Street 2:
Practice Address - City:VANDERBILT
Practice Address - State:MI
Practice Address - Zip Code:49795-9772
Practice Address - Country:US
Practice Address - Phone:989-199-2082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker