Active NPI
Bonnett NA Dulaney, LPC
- Case Manager/Care Coordinator
- Smyrna, GA
National Provider Identifier
1003097635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 004123
- Practice address
- 1330 Concord Rd SE
Smyrna, GA 30080-4375 - Phone
- (770) 861-8227
- NPI assigned
- Nov 26, 2007
- Last updated
- Nov 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 004123 | GA | Primary |
Addresses
Primary practice location
1330 Concord Rd SE
Smyrna, GA 30080-4375
Mailing address
2236 Asquith Ave SW
Marietta, GA 30008-6001
Phone (770) 861-8227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 15, 2024 through Oct 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004123 | GA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196035200000",
"number": "1003097635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2236 ASQUITH AVE SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300086001",
"telephone_number": "770-861-8227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 CONCORD RD SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300804375",
"telephone_number": "770-861-8227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DULANEY",
"first_name": "BONNETT",
"middle_name": "NA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-26",
"last_updated": "2007-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "GA",
"license": "004123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.