Provider Demographics
NPI:1245038785
Name:SEVLIE, JONATHAN DAVID (LAPC)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DAVID
Last Name:SEVLIE
Suffix:
Gender:
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 E BISMARCK EXPY
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-6744
Mailing Address - Country:US
Mailing Address - Phone:701-255-3325
Mailing Address - Fax:701-250-6469
Practice Address - Street 1:1833 E BISMARCK EXPY
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-6744
Practice Address - Country:US
Practice Address - Phone:701-255-3325
Practice Address - Fax:701-250-6469
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1425-3-1-25A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health