| Bonnie Rose Bury-blattman, LPC | |
|
2323 W Front St, Tyler, TX 75702-7747 | |
| (903) 597-1351 | |
| (903) 535-7384 |
| Full Name | Bonnie Rose Bury-blattman |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 2323 W Front St, 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 | Thrive Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215181300 PECOS PAC ID: 0749458420 Enrollment ID: O20210706003672 |
| Mailing Address | Practice Location Address |
|---|---|
| Bonnie Rose Bury-blattman, LPC 3400 Nne Loop 323 Trlr 34, Tyler, TX 75708-5607 Ph: (903) 714-1374 | Bonnie Rose Bury-blattman, LPC 2323 W Front St, Tyler, TX 75702-7747 Ph: (903) 597-1351 |
Sherry Marasse, MA, LPC Counselor Medicare: Medicare Enrolled Practice Location: 12863 Old Noonday Rd, Tyler, TX 75703 Phone: 903-941-2780 | |
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 | |
Lenore Strickland, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5207 Hollytree Dr Apt 905, Tyler, TX 75703 Phone: 903-539-3158 |