Provider Demographics
NPI:1295359081
Name:RINEHART, JONATHAN PAUL (LLMSW)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PAUL
Last Name:RINEHART
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 STATE ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4312
Mailing Address - Country:US
Mailing Address - Phone:616-514-3646
Mailing Address - Fax:
Practice Address - Street 1:311 STATE ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4312
Practice Address - Country:US
Practice Address - Phone:616-514-3646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011054381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical