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NPI Code Detail

MEDICARE: DR. JONATHAN CLEVELAND PH.D.

MEDICARE:  DR. JONATHAN  CLEVELAND  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist7473OH
2103T00000XPsychologist

General Provider Information

NPI Number : 1568910974
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN CLEVELAND PH.D.
Provider Business Mailing Address
First Line : 425 N FINDLAY ST
Second Line :
City : DAYTON
State : OH
Zip : 45404-2287
Country : US
Telephone Number : 937-716-7663
Fax Number :
Provider Business Practice Location Address
First Line : 6500 POE AVE STE 400
Second Line :
City : DAYTON
State : OH
Zip : 45414-2527
Country : US
Telephone Number : 937-276-3356
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2016
Last Update Date : 06/16/2025

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Directions to “ DR. JONATHAN CLEVELAND PH.D.” Practice Location

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