Provider Demographics
NPI:1013418953
Name:HAVEN, JONATHON (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:
Last Name:HAVEN
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:JONATHON
Other - Middle Name:
Other - Last Name:NEUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2801 W HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-1228
Mailing Address - Country:US
Mailing Address - Phone:773-945-9320
Mailing Address - Fax:
Practice Address - Street 1:5236 W NELSON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-4901
Practice Address - Country:US
Practice Address - Phone:630-537-0297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-20-44233103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst