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Individual
MR. JONATHAN MOORE CLOUD
Active
Individual
MR. JONATHAN MOORE CLOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C000512
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23153
NC HEALTH CHOICE
NC
05
—
6002795
—
NC
Enumeration date
01/28/2007
Last updated
07/08/2007
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