Individual ProviderJonathan MarcumSocial WorkerBehavioral Health & Social Service ProvidersPractice Address800 Zorn Ave, Social Work Service, Rex Vamc, Louisville, KY 40206-1433(502) 287-6196PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Marcum does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1548690050Provider TypeIndividualFull NameMarcum, JonathanCredentialLCSWGenderMaleSole ProprietorYesEnumeration Date11/19/2013Last Updated11/19/2013Contact InformationPractice LocationPractice Address800 Zorn Ave, Social Work Service, Rex Vamc, Louisville, KY 40206-1433Phone(502) 287-6196FaxUnlisted FaxMailing LocationMailing Address800 Zorn Ave, Social Work Service, Rex Vamc, Louisville, KY 40206-1433Phone(502) 287-6196FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense3796Kentucky