Jonathan Moore Cloud, LCSW

Individual provider Active NPI Mental Health Counselor · Oxford, NC

NPI 1528114709 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1528114709
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
C000512 (NC)
Practice address
120 Orange St Ste a
Oxford, NC 27565-3249
Phone
(336) 212-9048
NPI assigned
Jan 28, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C000512NCMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C000512 NC Yes

Addresses

Primary practice location

120 Orange St Ste a
Oxford, NC 27565-3249

Mailing address

2206 Somers Ave
Burlington, NC 27215-3338
Phone (336) 585-0140

Other identifiers

IdentifierTypeStateIssuer
23153OtherNCNC HEALTH CHOICE
6002795MedicaidNC

Other providers in Oxford, NC

All providers in Oxford, NC · Mental Health Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.