Provider Demographics
NPI:1336587575
Name:JONES, MICHELLE ANN (MSW, CADC, QMHP)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:MSW, CADC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 FARAON ST STE 120
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3512
Mailing Address - Country:US
Mailing Address - Phone:816-271-8133
Mailing Address - Fax:816-271-8134
Practice Address - Street 1:423 N MARKET ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-1614
Practice Address - Country:US
Practice Address - Phone:660-562-3000
Practice Address - Fax:660-562-3002
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MO20170253451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical