Healthcare Provider Details

I. General information

NPI: 1205745536
Provider Name (Legal Business Name): JONATHAN ERIK VAN ARNEMAN LAPC, R-DMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 S 47TH ST APT 1
PHILADELPHIA PA
19143-3773
US

IV. Provider business mailing address

1128 S 47TH ST APT 1
PHILADELPHIA PA
19143-3773
US

V. Phone/Fax

Practice location:
  • Phone: 445-208-9199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC001905
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: