| Bonnie Rose Bury-blattman, LPC | |
|
100 Independence Pl Ste 201, Tyler, TX 75703-1327 | |
| (903) 565-9022 | |
| (833) 953-1521 |
| Full Name | Bonnie Rose Bury-blattman |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 100 Independence Pl Ste 201, Tyler, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669937041 | NPI | - | NPPES |
| 396545103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 11745 (Texas) | Secondary |
| 101YP2500X | Counselor - Professional | 80342 (Texas) | Primary |
| Entity Name | Andrews Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821064742 PECOS PAC ID: 9739170770 Enrollment ID: O20040519001179 |
| Entity Name | Mt Enterprise Community Health Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649412354 PECOS PAC ID: 2860303922 Enrollment ID: O20110801000150 |
| Entity Name | Thrive Counseling And Life Coaching, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720744212 PECOS PAC ID: 2769833078 Enrollment ID: O20240111001846 |
| Mailing Address | Practice Location Address |
|---|---|
| Bonnie Rose Bury-blattman, LPC 10116 Sparks Dr, Tyler, TX 75704-3935 Ph: (903) 565-9022 | Bonnie Rose Bury-blattman, LPC 100 Independence Pl Ste 201, Tyler, TX 75703-1327 Ph: (903) 565-9022 |
Mr. Laramie C Selman, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4101 University Blvd, Tyler, TX 75701 Phone: 903-363-7704 | |
Mrs. Jill Marie Kirkley, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3800 Paluxy Dr, Ste 240, Tyler, TX 75703 Phone: 903-630-0422 | |
Mrs. Joy Louise Bevoni, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 14023 State Highway 155 S, Tyler, TX 75703 Phone: 903-534-0414 | |
Mr. David Comins Wheeler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5875 Grace Ave, Tyler, TX 75707 Phone: 903-316-5106 | |
Desiree Laurel Glaze, LPC S Counselor Medicare: Not Enrolled in Medicare Practice Location: 2003 Rickety Ln Ste E, Tyler, TX 75703 Phone: 903-330-0601 | |
Lakeisha Roquemore, LCDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1411 S Bennett Ave, Tyler, TX 75701 Phone: 903-535-7314 | |
Lenore Strickland, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5207 Hollytree Dr Apt 905, Tyler, TX 75703 Phone: 903-539-3158 |