Provider Demographics
NPI:1295260198
Name:JONES, WILLIE D (LMSW)
Entity type:Individual
Prefix:MR
First Name:WILLIE
Middle Name:D
Last Name:JONES
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 AUTO CLUB DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2749
Mailing Address - Country:US
Mailing Address - Phone:313-317-2000
Mailing Address - Fax:313-317-2090
Practice Address - Street 1:2215 FULLER RD # 116C
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2303
Practice Address - Country:US
Practice Address - Phone:734-769-7100
Practice Address - Fax:313-317-2090
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MI68010973661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical