Provider Demographics
NPI:1245004365
Name:MESCHES, JONATHAN (CDCA)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:MESCHES
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4952 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2335
Mailing Address - Country:US
Mailing Address - Phone:404-661-4687
Mailing Address - Fax:
Practice Address - Street 1:11100 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-1943
Practice Address - Country:US
Practice Address - Phone:216-664-4330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183279101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)