JONATHAN MICHAEL CLARK (NPI# 1831563105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831563105 |
| Entity Type | Individual |
| Full Name | JONATHAN MICHAEL CLARK |
| Credential | MA, MS, LPC, NBCC |
| Practice Address |
1522b Gregg St Philadelphia PA 19115-4283 |
| Practice Telephone | 2156981978 |
| Mailing Telephone | 2156981978 |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2015-11-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
PC008486 | PA | Behavioral Health & Social Service Providers |
| N | 101YS0200X |
Counselor Specialization: School |
9350568 | PA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790246270 | Jonathan Andrew Clark | Nurse Practitioner | 5042 12th Ave N, St Petersburg, FL 33710-6011 | 2019-03-27 |
| 1720573447 | Jonathan Clark | Specialist/Technologist | 1214 Highland Lake Cir, Decatur, GA 30033-3460 | 2018-06-25 |
| 1376033381 | Jonathan Clark | Psychologist | 150 Payson Rd, Chestnut Hill, MA 02467-3272 | 2018-05-15 |
| 1871046748 | Jonathan Clark | Acupuncturist | 1803 N Wickham Rd, Melbourne, FL 32935-8155 | 2016-07-27 |
| 1841696820 | Jonathan Clark | Specialist/Technologist | 14049 Scenic Hwy, Lookout Mountain, GA 30750-4100 | 2014-11-18 |
| 1932508165 | Jonathan Daniel Clark | Specialist/Technologist | 11306 County Line Rd, Madison, AL 35756-2011 | 2014-08-13 |
| 1851645717 | Jonathan Clark | Student in an Organized Health Care Education/Training Program | 206 Finley Forest Dr, Chapel Hill, NC 27517-8689 | 2012-10-30 |
| 1184682866 | Jonathan Scott Clark | Family Medicine | 1103 Dewey Ave, Poteau, OK 74953-4411 | 2006-05-03 |
| 1851740724 | Jonathan J Clark Jr. | Social Worker | 5901 E 7th St, Long Beach, CA 90822-5201 | 2016-06-10 |
| 1679943328 | Jonathan Wilson Clark | Occupational Therapist | 3175 Pocahontas Rd, Baker City, OR 97814-1434 | 2015-10-06 |
| Street Address |
1522B GREGG ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19115-4283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780043844 | Effective Interpersonal Counseling Services | Point of Service | 1522b Gregg St, Philadelphia, PA 19115-4283 | 2016-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442696 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2044 Red Lion Road, Philadelphia, PA 19115 | 2020-09-21 |
| 1639717762 | Cassondra Ondeck | Physical Therapist | Paul's Run Retirement Community, 9896 Bustleton Ave, Philadelphia, PA 19115 | 2019-12-19 |
| 1740747641 | Comfort Ride Transit Inc | Non-emergency Medical Transport (VAN) | 248 Geiger Road, Suite 201 Unit D, Philadelphia, PA 19115 | 2019-02-27 |
| 1386101400 | Ashley Thomas | Physician Assistant | 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 | 2019-02-25 |
| 1659857027 | Kiesha Anita Abney | Occupational Therapy Assistant | Chapel Manor (genesis Rehabilitation) 1104 Welsh Road, Philadelphia, PA 19115 | 2018-07-18 |
| 1457844870 | Philadelphia Discount Pharmacy LLC | Pharmacist | 842 Red Lion Road Unit 13, Philadephia, PA 19115 | 2018-06-11 |
| 1770001828 | Ciarra Bell | Occupational Therapist | 828 Red Lion Rd, Philadelphia, PA 19115 | 2017-09-08 |
| 1245604008 | Saria Ibrahim | Counselor | 9651 Clark Street, Philadelphia, PA 19115 | 2015-11-17 |
| 1124413166 | Global Dental Plus LLC | Dentist | 9630 Bustleton Av 2nd Fl, Philadelphia, PA 19115 | 2015-04-06 |
| 1932510161 | Miriam John | Occupational Therapist | 9997 Sandy Road, Philadelphia, PA 19115 | 2014-05-09 |
| Find all providers in zip 19115 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214928 | Tatyana Sharron Hill | Counselor | 3700 Market St Ste 301, Philadelphia, PA 19104-3143 | 2020-10-29 |
| 1013516806 | Being, LLC | Counselor | 1736 Kendrick St, Philadelphia, PA 19152-1816 | 2020-10-22 |
| 1821605809 | Jessica Briddell-hasben | Counselor | 829 Grakyn Ln, Philadelphia, PA 19128-2005 | 2020-09-24 |
| 1538776653 | Eric Brown | Counselor | 8227 Thouron Ave, Philadelphia, PA 19150-2018 | 2020-09-24 |
| 1740896661 | Keya Middleton | Counselor | 2030 N 56th St, Philadelphia, PA 19131-3132 | 2020-09-16 |
| 1679189641 | Teen Support Center, LLC | Counselor | 1528 Walnut St Ste 2012, Philadelphia, PA 19102-3613 | 2020-09-16 |
| 1982219879 | Dathan Landon-freeman | Counselor | 7201 Frankford Ave Ste 1017, Philadelphia, PA 19135-1010 | 2020-09-09 |
| 1700490422 | Outside The Box Strategies, LLC | Counselor | 5340 Angora Ter Fl 2, Philadelphia, PA 19143-3114 | 2020-09-01 |
| 1346853355 | Lauren Dattilo | Counselor | 10175 Bustleton Ave, Philadelphia, PA 19116-3718 | 2020-08-28 |
| 1487265229 | Staci A Robinson | Counselor | 3925 N Smedley St, Philadelphia, PA 19140-3420 | 2020-08-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19115 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.