Clark, Jonathan
Clark, Jonathan is an sole proprietor health care provider with primary practice located at 150 Payson Rd , Chestnut Hill MA 02467-3272. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Clark, Jonathan can be contacted via phone (617) 469-8370.Contact Information
Primary practice address
150 Payson Rd
Chestnut Hill MA 02467-3272
Phone: (617) 469-8370
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 810-PY-PR | Massachusetts |
Profile Details
| NPI number | 1376033381 |
|---|---|
| LBN Legal business name | Clark, Jonathan |
| Credentials | ED.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 15th, 2018 |
| Last updated | May 15th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376033381 | NPPES |
| Massachusetts | Other | 810-PY-PR | PSYCHOLOGIST |
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