Provider Demographics
NPI:1962590901
Name:JONES, CHERYL (LMSW)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39293 PLYMOUTH RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1060
Mailing Address - Country:US
Mailing Address - Phone:734-462-4999
Mailing Address - Fax:
Practice Address - Street 1:39293 PLYMOUTH RD
Practice Address - Street 2:SUITE 110
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1060
Practice Address - Country:US
Practice Address - Phone:734-462-4999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801172501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI048764OtherVALUE OPTIONS
MI7997057OtherAETNA
MI8008943420OtherBLUE CROSS