Provider Demographics
NPI:1801533997
Name:LEPORE, JONATHAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:LEPORE
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 1:1965 UPPER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREEN LANE
Mailing Address - State:PA
Mailing Address - Zip Code:18054-9400
Mailing Address - Country:US
Mailing Address - Phone:267-640-2007
Mailing Address - Fax:
Practice Address - Street 1:23 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1303
Practice Address - Country:US
Practice Address - Phone:484-893-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0191411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical