Individual provider Active NPI

Lynda Bonneau, LICSW

  • Clinical Social Worker
  • Greenville, RI
National Provider Identifier
1013155035
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW02209 Issued in RI
Practice address
29 Smith Ave Ste 1
Greenville, RI 02828-1726
Phone
(401) 618-5378
Fax
(855) 433-1793
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW02209 RI Primary

Addresses

Primary practice location

29 Smith Ave Ste 1
Greenville, RI 02828-1726

Mailing address

765 Allens Ave
Suite 102
Providence, RI 02905-5443
Phone (401) 490-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ISW02209RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
From the Ground Up Wellness Center, LLC Clinical CurrentSince Jun 23, 2025 Accepting new patients

Locations

29 Smith Ave
Ste 1
Greenville, RI 02828
Phone (401) 618-5378

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1013155035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ALLENS AVE",
            "address_2": "SUITE 102",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055443",
            "telephone_number": "401-490-8900",
            "fax_number": "401-490-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SMITH AVE STE 1",
            "city": "GREENVILLE",
            "state": "RI",
            "postal_code": "028281726",
            "telephone_number": "401-618-5378",
            "fax_number": "855-433-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEAU",
        "first_name": "LYNDA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW02209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.