Provider Demographics
NPI:1922121888
Name:SAPUNAR, JON MICHAEL (LISW)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:MICHAEL
Last Name:SAPUNAR
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 LORI LN
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-7937
Mailing Address - Country:US
Mailing Address - Phone:937-767-8897
Mailing Address - Fax:937-767-8897
Practice Address - Street 1:4144 CROSSGATE LN
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45236-1216
Practice Address - Country:US
Practice Address - Phone:513-791-7915
Practice Address - Fax:937-767-8897
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00074671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical