Nelson, Jonathan Richard
Nelson, Jonathan Richard is an sole proprietor health care provider with primary practice located at 900 N Swallow Tail Dr Ste 105 , Port Orange FL 32129-6103. He 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 / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Nelson, Jonathan Richard can be contacted via phone (386) 333-9717.Contact Information
Primary practice address
900 N Swallow Tail Dr Ste 105
Port Orange FL 32129-6103
Phone: (386) 333-9717
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | SW12912 | Florida |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW12912 | Florida |
Profile Details
| NPI number | 1629550744 |
|---|---|
| LBN Legal business name | Nelson, Jonathan Richard |
| Credentials | LCSW, MCAP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 5th, 2018 |
| Last updated | Sep 15th, 2018 - 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.
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