Provider Demographics
NPI:1750051967
Name:JONES, KRYSTI ELIANA (LLMSW)
Entity Type:Individual
Prefix:
First Name:KRYSTI
Middle Name:ELIANA
Last Name:JONES
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:KRYSTI
Other - Middle Name:ELIANA
Other - Last Name:HINCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:931 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5311
Mailing Address - Country:US
Mailing Address - Phone:314-422-7555
Mailing Address - Fax:
Practice Address - Street 1:1110 ELDON BAKER DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1923
Practice Address - Country:US
Practice Address - Phone:810-742-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851105505104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker