Provider Demographics
NPI:1902249931
Name:EICHER, JONATHAN D (LMSW, MBA)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:D
Last Name:EICHER
Suffix:
Gender:M
Credentials:LMSW, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 S BRYN MAWR AVE
Mailing Address - Street 2:FEDERATION HALL BLDG, JCHAI
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2105
Mailing Address - Country:US
Mailing Address - Phone:610-922-2480
Mailing Address - Fax:610-520-4705
Practice Address - Street 1:274 S BRYN MAWR AVE
Practice Address - Street 2:FEDERATION HALL BLDG, JCHAI
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2105
Practice Address - Country:US
Practice Address - Phone:610-922-2480
Practice Address - Fax:610-520-4705
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PASW129121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst