Individual
JON FADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAC, LCSW
Contact information
Practice address
1507 SPRING ST, JEFFERSONVILLE, IN 47130-2939
(407) 347-4536
Mailing address
1507 SPRING ST, JEFFERSONVILLE, IN 47130-2939
(407) 347-4536
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000979A
IN
1041C0700X
Clinical Social Worker
34010187A
IN
Other
Enumeration date
04/05/2014
Last updated
07/22/2025
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