Provider Demographics
NPI:1679026587
Name:STINNET, JODI (MSW)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:STINNET
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 OAK HOLLOW DR STE A
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5902
Mailing Address - Country:US
Mailing Address - Phone:231-929-7070
Mailing Address - Fax:231-929-1247
Practice Address - Street 1:1832 OAK HOLLOW DR STE A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5902
Practice Address - Country:US
Practice Address - Phone:231-929-7070
Practice Address - Fax:231-929-1247
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010201331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical