Provider Demographics
NPI:1639733108
Name:HAROLD, JONATHAN J
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:J
Last Name:HAROLD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 STANBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-5310
Mailing Address - Country:US
Mailing Address - Phone:215-618-5746
Mailing Address - Fax:
Practice Address - Street 1:252 N RADNOR CHESTER RD STE 1C
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-5113
Practice Address - Country:US
Practice Address - Phone:215-618-5746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPS019559103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health