Allisha Gayle Skinner Bonneaux, MED,LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

14019 Issued in TX

Practice address

7700 FM 1130
Orange, TX 77632-3740

Phone

(409) 988-4221

NPI assigned

Aug 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Mindmetier

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Orange, TX
  • NPI 1346832524
  NPD

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1063528966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 FM 1130",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776323740",
            "telephone_number": "409-988-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 FM 1130",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776323740",
            "telephone_number": "409-988-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEAUX",
        "first_name": "ALLISHA",
        "middle_name": "GAYLE SKINNER",
        "credential": "MED,LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "14019",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "14019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168911901",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Orange",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7700 Fm 1130",
            "city": "Orange",
            "state": "TX",
            "country_code": "US",
            "postal_code": "776323740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sylvia Dale Bickham
• Bio-Medical Applications of Texas, Inc.
• Biotronics Kidney Center of Beaumont, Inc
• Josh Bland, HIS
• Nicole Block
• Malinda Charisse Boudreaux, LPC
• Reatha Jeannette Bradberry I, FNP
• Tara Breaux, NP-C
• Brewer Dental PLLC
• Bright Branch ABA, LLC

• All providers in Orange, TX
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.