Individual
MR. JONATHAN MOORE CLOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
120 ORANGE ST STE A, OXFORD, NC 27565-3249
(336) 212-9048
Mailing address
2206 SOMERS AVE, BURLINGTON, NC 27215-3338
(336) 585-0140
(919) 603-5090
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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