Provider Demographics
NPI:1336440072
Name:LADD, JONATHAN FREDERIC JR (MSW)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:FREDERIC
Last Name:LADD
Suffix:JR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14504 PEBBLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4311
Mailing Address - Country:US
Mailing Address - Phone:301-309-8824
Mailing Address - Fax:301-309-8824
Practice Address - Street 1:14504 PEBBLEWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-4311
Practice Address - Country:US
Practice Address - Phone:301-309-8824
Practice Address - Fax:301-309-8824
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD033771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical