Provider Demographics
NPI:1750765319
Name:ASAYAG, JONATHAN S (LCSW, ACSW, CAADC)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:S
Last Name:ASAYAG
Suffix:
Gender:M
Credentials:LCSW, ACSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-1533
Mailing Address - Country:US
Mailing Address - Phone:484-725-0072
Mailing Address - Fax:
Practice Address - Street 1:215 W LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-1533
Practice Address - Country:US
Practice Address - Phone:484-725-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06162900104100000X
PACW020259104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker