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NPI Code Detail

MEDICARE: JONATHAN RAYMOND DOLAN LMHC

MEDICARE: JONATHAN RAYMOND DOLAN LMHC
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
1101YM0800XMental Health CounselorMH7909FL

General Provider Information

NPI Number : 1932226867
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN RAYMOND DOLAN LMHC
Provider Business Mailing Address
First Line : 2647 N ANDREWS AVE
Second Line :
City : WILTON MANORS
State : FL
Zip : 33311-2509
Country : US
Telephone Number : 954-564-9390
Fax Number : 954-564-9391
Provider Business Practice Location Address
First Line : 2647 N ANDREWS AVE
Second Line :
City : WILTON MANORS
State : FL
Zip : 33311-2509
Country : US
Telephone Number : 954-564-9390
Fax Number : 954-564-9391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2007
Last Update Date : 07/08/2007

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