=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871966150
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JONATHAN BEHLER LPC, LMHC, PHD, MA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2015
-----------------------------------------------------
Last Update Date | 03/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3916 S AMHERST HWY
-----------------------------------------------------
City | MADISON HEIGHTS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24572-5963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-269-9322
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3916 S AMHERST HWY
-----------------------------------------------------
City | MADISON HEIGHTS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24572-5963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-269-9322
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 0701012486
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 04767
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 11786
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------