Provider Demographics
NPI:1801222914
Name:SOBELMAN, JONATHAN MARK (LMHC)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:MARK
Last Name:SOBELMAN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4546
Mailing Address - Country:US
Mailing Address - Phone:954-655-6735
Mailing Address - Fax:
Practice Address - Street 1:721 E ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6345
Practice Address - Country:US
Practice Address - Phone:954-783-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health