Provider Demographics
NPI:1972214401
Name:MATOS FERREIRA, JONATHAN SR (MSW)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:MATOS FERREIRA
Suffix:SR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 6461
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-9511
Mailing Address - Country:US
Mailing Address - Phone:787-361-2183
Mailing Address - Fax:
Practice Address - Street 1:CARR 103 KM 8.0 REPARTO SOUCHET
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-0062
Practice Address - Country:US
Practice Address - Phone:787-361-2183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR141911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical