Jeffrey A Bonack, BA, MDIV

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5121-226 Issued in WI

Practice address

2669 N Richards St
Milwaukee, WI 53212-2850

Phone

(800) 438-1772

Fax

(262) 345-5562

NPI assigned

Sep 14, 2020

Last updated

Nov 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wisconsin Lutheran Child and Family Service IncGroup PAC ID 0749233898, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

State licenses

Practice roles

Locations

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.

• Wisconsin Lutheran Child and Family Service Inc

  dba Christian Family Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Germantown, WI
  • NPI 1083786628

  Professional

  Medicare reassignment Care Compare group NPD
• Wisconsin Lutheran Child & Family Service

  dba Christian Family Solutions

  • Counseling Psychologist
  • Milwaukee, WI
  • NPI 1790202851
  NPD (past)
• Wisconsin Lutheran Child & Family Service ,Inc.

  dba Christian Family Solutions

  • Adult Mental Health Clinic/Center
  • Milwaukee, WI
  • NPI 1548866528
  NPD (past)
• Wisconsin Lutheran Child & Family Services, Inc

  dba Christian Family Counseling

  • Adolescent and Children Mental Health Clinic/Center
  • Brookfield, WI
  • NPI 1194961474

  Professional

  NPD (past)

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1033724299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224799",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 N RICHARDS ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122850",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16535 W Bluemound Rd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055936",
            "country_code": "US",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONACK",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "BA, MDIV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-14",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5121-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeleine L Boman, BS
• Zoe Marie Bomba, PA-C
• Erik Keith Bommersbach, PHARMD
• Camila Locci Bomtempo, M.D.
• Charles A Bomzer, MD
• George Fred Bonadurer III, MD
• Matthew Bonasch
• Holly L Bonavia, PA-C
• April K Bond
• Yolanda Renee Bond, NP

• Professional Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.