Provider Demographics
NPI:1417978552
Name:DR. JONATHAN ISAACSON, INC.
Entity Type:Organization
Organization Name:DR. JONATHAN ISAACSON, INC.
Other - Org Name:THE MARRIAGE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:216-292-4500
Mailing Address - Street 1:3659 GREEN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5715
Mailing Address - Country:US
Mailing Address - Phone:216-292-4500
Mailing Address - Fax:216-373-0085
Practice Address - Street 1:3659 GREEN RD STE 100
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5715
Practice Address - Country:US
Practice Address - Phone:216-292-4500
Practice Address - Fax:216-373-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6226103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty