Individual
JONATHAN MARK LINDSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
207 W JEFFERSON ST, SUITE 404, BLOOMINGTON, IL 61701-3960
(309) 323-0215
Mailing address
207 W JEFFERSON ST, SUITE 404, BLOOMINGTON, IL 61701-3960
(309) 323-0215
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180007462
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
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Other
Enumeration date
06/18/2007
Last updated
01/02/2013
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