Individual provider Active NPI

Laurel A Bonney, L.C.S.W.

  • Clinical Social Worker
  • Danbury, CT
National Provider Identifier
1003953787
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10076 Issued in CT
Practice address
100 Mill Plain Rd FL 3
Danbury, CT 06811-5178
Phone
(203) 546-3414
Fax
(203) 546-3455
NPI assigned
Jan 31, 2007
Last updated
Dec 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904005161 VA
Clinical Social Worker 1041C0700X 73078336 NY
Clinical Social Worker 1041C0700X 10076 CT Primary
Clinical Social Worker 1041C0700X SW12263 FL

Addresses

Primary practice location

100 Mill Plain Rd FL 3
Danbury, CT 06811-5178

Mailing address

100 Mill Plain Rd FL 3
Danbury, CT 06811-5178
Phone (203) 546-3414

Other identifiers 1

IdentifierTypeStateIssuer
010037328MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180131000338 CT Practitioner - Clinical Social Worker 7517285984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7 Kenosia Ave
Danbury, CT 06810-7395
Phone (475) 329-2677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10076CTMDClinical Social Worker
73078336NYMDClinical Social Worker
0904005161VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Institute for Neuropsychiatry and Behavioral Med Clinical CurrentSince Dec 18, 2017 Accepting new patients

Locations

100 Mill Plain Rd
Fl 3
Danbury, CT 06811
Phone (203) 546-3414

7 Kenosia Ave
Danbury, CT 06810
Phone (475) 329-2677

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1003953787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MILL PLAIN RD FL 3",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068115178",
            "telephone_number": "203-546-3414",
            "fax_number": "203-546-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MILL PLAIN RD FL 3",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068115178",
            "telephone_number": "203-546-3414",
            "fax_number": "203-546-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEY",
        "first_name": "LAUREL",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005161",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73078336",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10076",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010037328",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.