Provider Demographics
NPI:1831955640
Name:MAURER, JONATHAN S (LPC)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:S
Last Name:MAURER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42009 VICTORY LN
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6269
Mailing Address - Country:US
Mailing Address - Phone:703-554-0800
Mailing Address - Fax:
Practice Address - Street 1:9507 GAUGE DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX STATION
Practice Address - State:VA
Practice Address - Zip Code:22039-3210
Practice Address - Country:US
Practice Address - Phone:703-677-6879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional