Provider Demographics
NPI:1932077385
Name:JONES, WHITNEY LACRYSTAL
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LACRYSTAL
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 LYDIA ST
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-3249
Mailing Address - Country:US
Mailing Address - Phone:847-313-8013
Mailing Address - Fax:
Practice Address - Street 1:1910 1ST ST STE 2N
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3145
Practice Address - Country:US
Practice Address - Phone:804-301-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician