Jonathan Woodard, LMFT #123611

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

123611 Issued in CA

Practice address

770 E Shaw Ave Ste 230
Fresno, CA 93710-7708

Phone

(559) 691-6840

NPI assigned

Aug 6, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Valley Family Therapy Corp

  • Marriage & Family Therapist
  • Fresno, CA
  • NPI 1205372711
  NPD
• Eminence Healthcare, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fresno, CA
  • NPI 1881060242
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1356895429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 E SHAW AVE STE 230",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107708",
            "telephone_number": "559-691-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 E SHAW AVE STE 230",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107708",
            "telephone_number": "559-691-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "JONATHAN",
        "credential": "LMFT #123611",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-06",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "123611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Wood, L.C.S.W.
• Mark Goff Wood, MD
• Rande Phillips Wood, M.A.
• Robbyn Wood
• Sammantha J Wood
• Brandon Woodbury, M.D.
• Brent L Woodbury, DPM
• Laura Ann Woodend
• Matthew Brunson Woodle, MD
• John Tyler Woodley, DO

• Mental Health Counselor in Fresno, CA
• Providers in Fresno, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.