Jonathan D Douglass, MA, LAC
Counselor, Professional in Northfield, New Jersey
1093059859- Practice location
- 1750 Zion RD Ste 209, Northfield, NJ 08225-1844
- Phone
- 609-204-6134
- Fax
- 570-864-3353
- Last updated
- November 18, 2012
Jonathan David Douglass is a Counselor, Professional based in Northfield, NJ. Jonathan David Douglass practices in Northfield, NJ and has the professional credentials of MA, LAC. The NPI Number for Jonathan David Douglass is 1093059859 and holds a License No. 37AC00141100 (NJ). The current practice location address for Jonathan David Douglass is 1750 Zion RD Ste 209, Northfield, NJ 08225-1844 and can be reached out via phone at 609-204-6134 and via fax at 570-864-3353.
Provider Profile Details
- NPI Number
- 1093059859
- Provider Name
- Jonathan David Douglass
- Credential
- MA, LAC
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1750 Zion RD Ste 209, Northfield, NJ 08225-1844
- Phone Number
- 609-204-6134
- Fax Number
- 570-864-3353
- Primary Taxonomy
- Counselor, Professional · 101YP2500X
- Sole Proprietor
- No
- Provider Enumeration Date
- November 18, 2012
- Last Update Date
- November 18, 2012
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1750 Zion RD Ste 209
Northfield, NJ 08225-1844 - City
- Northfield
- State
- New Jersey
- Zip
- 08225-1844
- Phone Number
- 609-204-6134
- Fax Number
- 570-864-3353
Provider Business Mailing Address Details
- Address
- 1750 Zion RD Ste 209
Northfield, NJ 08225-1844 - City
- Northfield
- State
- NJ
- Zip
- 08225-1844
- Phone Number
- 609-204-6134
- Fax Number
- 570-864-3353
License Information
- License Number (1)
- 37AC00141100
- License State (1)
- NJ
- Taxonomy (1)
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X
- License Number (2)
- 37AC00141100
- License State (2)
- NJ
- Taxonomy (2)
- Counselor, Professional · 101YP2500X · Primary
- License Number (3)
- 37AC00141100
- License State (3)
- NJ
- Taxonomy (3)
- Marriage & Family Therapist · 106H00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Jonathan D Douglass, MA, LAC?
The NPI number of Jonathan D Douglass, MA, LAC is 1093059859. It was assigned on November 18, 2012 and is currently active in the NPPES registry.
What is the specialty of Jonathan D Douglass, MA, LAC?
Jonathan D Douglass, MA, LAC is registered under the primary taxonomy Counselor, Professional (code 101YP2500X), licensed in NJ under license number 37AC00141100.
Where does Jonathan D Douglass, MA, LAC practice?
The practice location is 1750 Zion RD Ste 209, Northfield, NJ 08225-1844. The office can be reached at 609-204-6134 (phone) or 570-864-3353 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1093059859 directly on the NPPES registry website.