Provider Demographics
NPI:1043606437
Name:TOLBERT, JONATHAN T (LPC)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:T
Last Name:TOLBERT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:JONATHAN
Other - Middle Name:T
Other - Last Name:TOLBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:1701 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-5308
Mailing Address - Country:US
Mailing Address - Phone:330-749-5081
Mailing Address - Fax:
Practice Address - Street 1:2000 NOBLE DR
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-5353
Practice Address - Country:US
Practice Address - Phone:330-264-3232
Practice Address - Fax:330-264-3879
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1451142104100000X
OHC.2204686106H00000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist