Clark, Jonathan Michael

Clark, Jonathan Michael is an sole proprietor health care provider with primary practice located at 1522B Gregg St , Philadelphia PA 19115-4283. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Clark, Jonathan Michael can be contacted via phone (215) 698-1978.

Contact Information

Primary practice address
1522B Gregg St Philadelphia PA 19115-4283
Phone: (215) 698-1978
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X PC008486 Pennsylvania
Behavioral Health & Social Service Providers / School 101YS0200X 9350568 Pennsylvania

Profile Details

NPI number 1831563105
LBN Legal business name Clark, Jonathan Michael
Credentials MA, MS, LPC, NBCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 23rd, 2015
Last updated Nov 23rd, 2015 - about 9 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.

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