Provider Demographics
NPI:1942708243
Name:CEFUS, JON MICHAEL (LPCC)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:MICHAEL
Last Name:CEFUS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 W HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-2071
Mailing Address - Country:US
Mailing Address - Phone:330-364-9360
Mailing Address - Fax:330-364-9769
Practice Address - Street 1:1029 W HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2071
Practice Address - Country:US
Practice Address - Phone:330-364-9360
Practice Address - Fax:330-364-9769
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800537101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional