Provider Demographics
NPI:1376672816
Name:MARCUS, JONATHAN PAUL (LICSW)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:PAUL
Last Name:MARCUS
Suffix:
Gender:M
Credentials:LICSW
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Mailing Address - Street 1:1 WASHINGTON ST
Mailing Address - Street 2:COMMUNITY COUNSELING OF BRISTOL COUNTY
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3960
Mailing Address - Country:US
Mailing Address - Phone:508-977-8041
Mailing Address - Fax:508-828-9146
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:COMMUNITY COUNSELING OF BRISTOL COUNTY
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3960
Practice Address - Country:US
Practice Address - Phone:508-977-8041
Practice Address - Fax:508-828-9146
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA10210571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical