Boydston, Jonathan Craig

Boydston, Jonathan Craig is an individual health care provider with primary practice located at 13936 Grover Rd. , Jacksonville FL 32226-5063. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Boydston, Jonathan Craig can be contacted via phone (850) 855-8601.

Contact Information

Primary practice address
13936 Grover Rd. Jacksonville FL 32226-5063
Phone: (850) 855-8601
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW 1874 Florida

Profile Details

NPI number 1629042080
LBN Legal business name Boydston, Jonathan Craig
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Apr 25th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629042080 NPPES
Florida MEDICAID 761910300

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