Provider Demographics
NPI:1558628388
Name:SANKEY, KRYSTIN (MS)
Entity Type:Individual
Prefix:
First Name:KRYSTIN
Middle Name:
Last Name:SANKEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KRYSTIN
Other - Middle Name:
Other - Last Name:JENKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:13101 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2216
Mailing Address - Country:US
Mailing Address - Phone:734-785-7700
Mailing Address - Fax:
Practice Address - Street 1:4520 LINDEN CREEK PKWY STE B
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2969
Practice Address - Country:US
Practice Address - Phone:810-777-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MI6401010403101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health