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General NPI Number Information
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NPI Number | 1174267421
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Entity Type | Organization
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Legal Business Name | MICHELE JONAS PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 4711 GOLF RD STE 400
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City | SKOKIE
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State | IL
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Zip | 60076-1242
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Country | US
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Telephone | 224-307-4074
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 NOYES ST
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City | EVANSTON
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State | IL
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Zip | 60201-2636
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Country | US
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Telephone | 224-307-4074
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. MICHELE JONAS
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Credential | PHD
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Telephone | 224-307-4074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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