Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan Distaulo, PLPC

Individual provider Professional Counselor · NPI 1801300637

Jonathan Distaulo, PLPC is a Professional Counselor in Springfield, Missouri. Licensed in Missouri. Registered with an NPI since 2017.

Licensed in
MO
In the registry since
2017

Practice location Address checks out

3101C S Kimbrough Ave
Springfield, MO 65807-5011
Phone: (417) 866-7773
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 2017041286 (MO)

Record details

NPI number1801300637
Entity typeIndividual (Type 1)
GenderMale
Credentials PLPC
Sole proprietorNo
NPI enumeratedDecember 1, 2017
Last updated in NPPESDecember 1, 2017
Mailing address3101c S Kimbrough Ave, Springfield, MO 65807-5011

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