Provider Demographics
NPI:1932769437
Name:JONES, CHRISTINA
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
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 1:75 EXECUTIVE DR STE 337
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8152
Mailing Address - Country:US
Mailing Address - Phone:331-444-2618
Mailing Address - Fax:844-802-2872
Practice Address - Street 1:75 EXECUTIVE DR STE 337
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8152
Practice Address - Country:US
Practice Address - Phone:331-444-2618
Practice Address - Fax:844-802-2872
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178015910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty