| Bonnie Kathleen Lcsw Pllc | |
|
900 Doe Run Trl Van Buren AR 72956-7382 | |
| (479) 414-4652 | |
| Not Available |
| Full Name | Bonnie Kathleen Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 900 Doe Run Trl, Van Buren, Arkansas |
| Authorized Official Name and Position | Bonnie Morton (OWNER) |
| Authorized Official Contact | 4794144652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonnie Kathleen Lcsw Pllc 900 Doe Run Trl Van Buren AR 72956-7382 Ph: (479) 414-4652 | Bonnie Kathleen Lcsw Pllc 900 Doe Run Trl Van Buren AR 72956-7382 Ph: (479) 414-4652 |
| NPI Number | 1710678180 |
|---|---|
| Provider Enumeration Date | 05/17/2023 |
| Last Update Date | 05/17/2023 |
| Certification Date | 05/17/2023 |
| Medicare PECOS PAC ID | 3678917911 |
|---|---|
| Medicare Enrollment ID | O20240214004315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710678180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bonnie K Morton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023391505 PECOS PAC ID: 4587092523 Enrollment ID: I20200325001492 |
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