Provider Demographics
NPI:1578982765
Name:CHWIRUT, JONATHAN R (BCABA)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:R
Last Name:CHWIRUT
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-2810
Mailing Address - Country:US
Mailing Address - Phone:703-496-4371
Mailing Address - Fax:
Practice Address - Street 1:7000 OAK FOREST LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-2124
Practice Address - Country:US
Practice Address - Phone:240-672-2386
Practice Address - Fax:443-221-4486
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0-14-5875103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst