Jones, Ilissa

Jones, Ilissa is an sole proprietor health care provider with primary practice located at 12814 Lake Blvd , Lindstrom MN 55045-9345. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jones, Ilissa can be contacted via phone (651) 755-4276.

Contact Information

Primary practice address
12814 Lake Blvd Lindstrom MN 55045-9345
Phone: (651) 755-4276
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 303793 Minnesota
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1487203030
LBN Legal business name Jones, Ilissa
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2019
Last updated Sep 6th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1487203030 NPPES
Minnesota MEDICAID 1174955397

Popular Providers