Provider Demographics
NPI:1679992705
Name:JONES, DEAMPHRA MICHELE (LLPC)
Entity Type:Individual
Prefix:MS
First Name:DEAMPHRA
Middle Name:MICHELE
Last Name:JONES
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 CHAMBERLAIN ST APT 1008
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1785
Mailing Address - Country:US
Mailing Address - Phone:810-219-1773
Mailing Address - Fax:810-820-9438
Practice Address - Street 1:550 CHAMBERLAIN ST APT 1008
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-1785
Practice Address - Country:US
Practice Address - Phone:810-219-1773
Practice Address - Fax:810-820-9438
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MI6401015654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor