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General NPI Number Information
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NPI Number | 1316289531
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Entity Type | Organization
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Legal Business Name | JONATHAN STERN, M.S., L.P.C., L.A.D.C., COUNSELING AND PSYCHOTHERAPY S
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 2911 DIXWELL AVE SUITE B-5
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City | HAMDEN
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State | CT
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Zip | 06518-3195
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Country | US
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Telephone | 203-916-5496
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Fax | 203-265-1216
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Provider Business Mailing Address
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Address Line | 2911 DIXWELL AVE SUITE B-5
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City | HAMDEN
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State | CT
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Zip | 06518-3195
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Country | US
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Telephone | 203-916-5496
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Fax | 203-265-1216
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Authorized Official
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Title or Position | OWNER
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Name | MR. JONATHAN DAVID STERN
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Credential | L.P.C., L.A.D.C.
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Telephone | 203-213-9987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 000823
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001882
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License Number State | CT
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