Provider Demographics
NPI:1821534702
Name:TARR, JONATHON (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JONATHON
Middle Name:
Last Name:TARR
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 1:1850 LEE RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2115
Mailing Address - Country:US
Mailing Address - Phone:407-221-0598
Mailing Address - Fax:321-316-4863
Practice Address - Street 1:1850 LEE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2115
Practice Address - Country:US
Practice Address - Phone:407-221-0598
Practice Address - Fax:321-316-4863
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 14606101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health