| Doctor Name: | MR. JONATHAN DEAN PONSER |
| NPI Number: | 1003045337 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., LCPC, NCC |
| License Number: | 180007267 |
| Business Practice Address: | 901 N 1st St Springfield, IL - 627023759 |
| Business Phone Number: | 2177884065 |
| Business Fax Number: | 2177788414 |
| Mailing Address: | 710 N 8th St, SPRINGFIELD |
| State: | IL |
| Postal Code: | 627026324 |
| Phone Number: | 2175251064 |
| Fax Number: | 2175251651 |
| NPI Enumeration Date: | 07/08/2009 |
| NPI Last Update Date: | 10/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180007267 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |