# JONATHAN M. LEAGUE PRIVATE PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Adult, Child, Family Counseling of Mason
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649523192
- **Authorized official:** MR. JONATHAN M. LEAGUE LPCC-S, LICDC (OWNER)
- **Authorized official phone:** (513) 229-8386

## Contact information

- **Practice address:** 6400 THORNBERRY CT STE 620, MASON, OH 45040-7818
- **Practice address phone:** (513) 229-8386
- **Practice address fax:** (513) 229-8385
- **Mailing address:** 6400 THORNBERRY CT STE 620, MASON, OH 45040-7818
- **Mailing address phone:** (513) 229-8386
- **Mailing address fax:** (513) 229-8385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 021055 | OH | — |
| 101YM0800X | Mental Health Counselor | E. 0004364 | OH | Yes |

## Other

- **Enumeration date:** 10/22/2012
- **Last updated:** 10/22/2012