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General NPI Number Information
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NPI Number | 1417978552
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Entity Type | Organization
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Legal Business Name | DR. JONATHAN ISAACSON, INC.
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 3659 GREEN RD STE 100
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City | BEACHWOOD
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State | OH
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Zip | 44122-5715
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Country | US
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Telephone | 216-292-4500
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Fax | 216-373-0085
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Provider Business Mailing Address
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Address Line | 3659 GREEN RD STE 100
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City | BEACHWOOD
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State | OH
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Zip | 44122-5715
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Country | US
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Telephone | 216-292-4500
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Fax | 216-373-0085
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JONATHAN ISAACSON
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Credential | PH.D.
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Telephone | 216-292-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6226
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License Number State | OH
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