Nelson, Jonathan Richard

Nelson, Jonathan Richard is an sole proprietor health care provider with primary practice located at 900 N Swallow Tail Dr Ste 105 , Port Orange FL 32129-6103. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Nelson, Jonathan Richard can be contacted via phone (386) 333-9717.

Contact Information

Primary practice address
900 N Swallow Tail Dr Ste 105 Port Orange FL 32129-6103
Phone: (386) 333-9717
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X SW12912 Florida
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW12912 Florida

Profile Details

NPI number 1629550744
LBN Legal business name Nelson, Jonathan Richard
Credentials LCSW, MCAP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 5th, 2018
Last updated Sep 15th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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