Individual
MR. JONATHAN KIRKLAND BLAUVELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCADC
Contact information
Practice address
2139 HWY 35 STE 120, HOLMDEL, NJ 07733-1094
(855) 698-3554
Mailing address
1417 BRACE RD STE C, CHERRY HILL, NJ 08034-3524
(856) 795-0036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00306900
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
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Other
Enumeration date
02/24/2014
Last updated
06/21/2022
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