Individual
DR. JONATHAN PROCTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
100 N VILLAGE AVE STE 18, ROCKVILLE CENTRE, NY 11570-3712
(917) 520-9366
Mailing address
100 N VILLAGE AVE STE 18, ROCKVILLE CENTRE, NY 11570-3712
(917) 520-9366
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
007837
NY
101YP2500X
Professional Counselor
74384
TX
103TC1900X
Counseling Psychologist
007837
NY
103TC2200X
Clinical Child & Adolescent Psychologist
007837
NY
Other
Enumeration date
09/08/2015
Last updated
11/18/2024
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