Provider Demographics
NPI:1295435246
Name:PIZZO, JONATHON (CDCA)
Entity type:Individual
Prefix:
First Name:JONATHON
Middle Name:
Last Name:PIZZO
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:JONATHON
Other - Middle Name:
Other - Last Name:PIZZO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDCA
Mailing Address - Street 1:3450 E FOSTER MAINEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-8538
Mailing Address - Country:US
Mailing Address - Phone:513-207-2113
Mailing Address - Fax:
Practice Address - Street 1:25 WHITNEY DR STE 120
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-8400
Practice Address - Country:US
Practice Address - Phone:513-654-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.182147101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)