Individual provider Active NPI

Bonnie Jean Nicole Mullett, TCADC

  • Addiction (Substance Use Disorder) Counselor
  • Covington, KY
National Provider Identifier
1053896506
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
251828 Issued in KY
Practice address
1610 Madison Ave
Covington, KY 41011-3318
Phone
(866) 934-7450
NPI assigned
Oct 1, 2018
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 251828 KY Primary

Addresses

Primary practice location

1610 Madison Ave
Covington, KY 41011-3318

Mailing address

4600 Montgomery Rd Ste 400
Cincinnati, OH 45212-2600

Other names 1

  • Bonnie Jean Nicole Manns Former name

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
251828KYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1053896506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MADISON AVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113318",
            "telephone_number": "866-934-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLETT",
        "first_name": "BONNIE",
        "middle_name": "JEAN NICOLE",
        "credential": "TCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "251828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "MANNS",
            "middle_name": "JEAN NICOLE",
            "credential": "TCADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Covington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.