Provider Demographics
NPI:1053995365
Name:RIOS, JONATHAN (MS LMHC)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:RIOS
Suffix:
Gender:M
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2937 E COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8216
Mailing Address - Country:US
Mailing Address - Phone:540-388-7302
Mailing Address - Fax:
Practice Address - Street 1:1660 CYPRESS DR STE 3
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33469-3198
Practice Address - Country:US
Practice Address - Phone:540-388-7302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health