Individual
MR. JONATHAN R BERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
555 HERITAGE RD, SUITE 104, SOUTHBURY, CT 06488-3846
(203) 264-5030
Mailing address
555 HERITAGE RD, SUITE 104, SOUTHBURY, CT 06488-3846
(203) 264-5030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005443
CT
1041C0700X
Clinical Social Worker
113787
MA
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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