Provider Demographics
NPI:1184422545
Name:JAEGER, TINA (MA, LLPC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:JAEGER
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 E HILL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5424
Mailing Address - Country:US
Mailing Address - Phone:810-771-8629
Mailing Address - Fax:
Practice Address - Street 1:2290 E HILL RD STE 103
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5424
Practice Address - Country:US
Practice Address - Phone:810-771-8629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024039101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor