Lisa Maria Bonaviso

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

011641 Issued in NY

Practice address

280 N Central Ave Ste 309
Hartsdale, NY 10530-1839

Phone

(914) 471-5516

NPI assigned

Oct 29, 2019

Last updated

May 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Lisa Bonaviso Mental Health Counseling PLLC

  • Counselor
  • Armonk, NY
  • NPI 1871212050
  NPD Authorized official
• Boston Children's Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967
  NPD (past)
• Boston Childrens Health Physicians LLP

  dba Boston Childrens Health Physicians Pediatric Endocrinology Division

  • Clinical Medical Laboratory
  • Sleepy Hollow, NY
  • NPI 1588651079
  NPD (past)

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1093359564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 FAWN LN",
            "city": "ARMONK",
            "state": "NY",
            "postal_code": "105041126",
            "telephone_number": "914-471-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 N CENTRAL AVE STE 309",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301839",
            "telephone_number": "914-471-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONAVISO",
        "first_name": "LISA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "701 Bedford Rd Ste B",
            "city": "Bedford Hills",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105071528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "688 Post Rd Ste 232",
            "city": "Scarsdale",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105835015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Reena Blum, LCSW
• Shanya Blye-Watt, LPN
• Leslie Bogen, JD, PHD
• Hipolito Taeza Bolanos, PT
• Fredric Bomback, MD
• Sharon Lorraine Bond Akuamoah
• Jennifer Bone
• Norma Luz Borrero-Large, LCSW
• Amber Bovenschulte
• Sara Boyd

• Mental Health Counselor in Hartsdale, NY
• Providers in Hartsdale, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.