Provider Demographics
NPI:1770618324
Name:KAPLAN, JONATHAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:TWIN LAKES
Mailing Address - State:WI
Mailing Address - Zip Code:53181-9615
Mailing Address - Country:US
Mailing Address - Phone:262-877-8734
Mailing Address - Fax:
Practice Address - Street 1:215 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046-8529
Practice Address - Country:US
Practice Address - Phone:847-245-6574
Practice Address - Fax:847-245-6714
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0034940429OtherBCBS