| Mr Xavier Antonio Bonilla, PHD | |
|
4 W Main St, New Market, MD 21774-6290 | |
| (301) 381-4586 | |
| (240) 563-0460 |
| Full Name | Mr Xavier Antonio Bonilla |
|---|---|
| Gender | Male |
| Speciality | Clinical Psychologist |
| Experience | 10 Years |
| Location | 4 W Main St, New Market, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922384999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 07314 (Maryland) | Primary |
| 101YM0800X | Counselor - Mental Health | LC4176 (Maryland) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Green Valley Therapy, L.l.c. | 1850738493 | 7 |
| Entity Name | Green Valley Therapy, L.l.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457069858 PECOS PAC ID: 1850738493 Enrollment ID: O20240319001961 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Xavier Antonio Bonilla, PHD 4 W Main St, New Market, MD 21774-6290 Ph: (301) 381-4586 | Mr Xavier Antonio Bonilla, PHD 4 W Main St, New Market, MD 21774-6290 Ph: (301) 381-4586 |
Mrs. Jennifer Luhrs Perone, M.A. CAGS Psychologist Medicare: Not Enrolled in Medicare Practice Location: 125 W Main St, New Market, MD 21774 Phone: 227-203-2400 | |
Dr. Rollo Warren Jones Jr., Psychologist Medicare: Not Enrolled in Medicare Practice Location: 10707 Grangerford Ct, New Market, MD 21774 Phone: 240-439-0627 | |
Dr. Anjali Jain, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 11247 Country Club Rd, New Market, MD 21774 Phone: 240-457-9830 |