Provider Demographics
NPI:1326511866
Name:JONES, CRISTYN JENE' (LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:CRISTYN
Middle Name:JENE'
Last Name:JONES
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:CRISTYN
Other - Middle Name:JENE'
Other - Last Name:COLVARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30525 PARDO AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135
Mailing Address - Country:US
Mailing Address - Phone:734-752-1473
Mailing Address - Fax:
Practice Address - Street 1:35300 NANKIN BLVD.
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:734-752-1473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851110219104100000X
MI171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator