Provider Demographics
NPI:1083001838
Name:METTER, JONATHAN (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:METTER
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 COULTER AVE
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2410
Mailing Address - Country:US
Mailing Address - Phone:484-222-3076
Mailing Address - Fax:
Practice Address - Street 1:17337 VENTURA BLVD
Practice Address - Street 2:#327
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3903
Practice Address - Country:US
Practice Address - Phone:818-856-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT89090106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist