Individual provider Active NPI

Bonnie L Connolly, LPC

  • Mental Health Counselor
  • Elkhorn, WI
National Provider Identifier
1043204563
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LI2718125 Issued in WI
Practice address
1 1/2 W Geneva St
Credence Therapy Associates
Elkhorn, WI 53121-1722
Phone
(262) 723-3424
Fax
(262) 723-8308
NPI assigned
Sep 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LI2718125 WI Primary

Addresses

Primary practice location

1 1/2 W Geneva St
Credence Therapy Associates
Elkhorn, WI 53121-1722

Mailing address

1 1/2 W Geneva St
Credence Therapy Associates
Elkhorn, WI 53121-1722
Phone (262) 723-3424

Other identifiers 5

IdentifierTypeStateIssuer
39799400OtherWICENPATICO
39799400MedicaidWI
1059860OtherCIGNA
13042OtherWIDEAN CARE
39799400OtherWIHIRSP

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
LI2718125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
American Behavioral Clinics, SC Past Accepting new patients
Credence Therapy Associates Inc PastSince Aug 1, 2002 Accepting new patients

Organizations & group practices 2

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1043204563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 1/2 W GENEVA ST",
            "address_2": "CREDENCE THERAPY ASSOCIATES",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211722",
            "telephone_number": "262-723-3424",
            "fax_number": "262-723-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 1/2 W GENEVA ST",
            "address_2": "CREDENCE THERAPY ASSOCIATES",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211722",
            "telephone_number": "262-723-3424",
            "fax_number": "262-723-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "BONNIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "LI2718125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CENPATICO",
            "identifier": "39799400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39799400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1059860",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN CARE",
            "identifier": "13042",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIRSP",
            "identifier": "39799400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.