JONATHAN DISTAULO PLPC
NPI 1801300637
Counselor - Professional in Springfield, MO

Q: What is Jonathan Distaulo's NPI number?

The NPI number for Jonathan Distaulo is 1801300637. It was assigned to this individual provider in the NPPES registry on December 1, 2017.

Q: What is Jonathan Distaulo's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Distaulo was last updated on December 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 01, 2017

3101C S KIMBROUGH AVE, SPRINGFIELD, MO 65807(417) 866-7773 Get Directions Write a Review

NPPES record last updated: December 1, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jonathan Distaulo Plpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN DISTAULO PLPC (NPI 1801300637) is an individual professional provider in Springfield, Missouri, licensed in Missouri (2017041286) and active in the NPI registry since December 2017.

NPPES Registry Identity

NPI1801300637

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameJONATHAN DISTAULOCredential: PLPC

Location Address3101C S KIMBROUGH AVESpringfield, MO 65807-5011

Mailing Address3101c S Kimbrough AveSpringfield, MO 65807-5011

Phone(417) 866-7773

Sole ProprietorNo

Enumeration DateDecember 1, 2017

✔ NPI 1801300637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MO · 2017041286

3101C S KIMBROUGH AVE, Springfield, MO 65807

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA TATE

Counselor

3101C S KIMBROUGH AVE
SPRINGFIELD, MO 65807

Greene County (417) 866-7773

MS. KELLI MARIE WINDES

Counselor

3101C S KIMBROUGH AVE
SPRINGFIELD, MO 65807

Greene County (417) 866-7773

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Distaulo's NPI number?

The NPI number for Jonathan Distaulo is 1801300637. It was assigned to this individual provider in the NPPES registry on December 1, 2017.

Where is Jonathan Distaulo located?

Jonathan Distaulo practices at 3101C S Kimbrough Ave, Springfield, MO 65807. The listed phone number is (417) 866-7773.

What is Jonathan Distaulo's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Jonathan Distaulo was last updated on December 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.