Active NPI
Bonnie Bleu Yardley, LAC
- Professional Counselor
- Mesa, AZ
National Provider Identifier
1114480449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LAC-16459
- Practice address
- 1234 S Power Rd Ste 250
Mesa, AZ 85206-3742 - Phone
- (602) 633-5032
- NPI assigned
- Apr 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LAC-16459 | AZ | Primary |
Addresses
Primary practice location
1234 S Power Rd Ste 250
Mesa, AZ 85206-3742
Mailing address
630 N Windsor
Mesa, AZ 85213-6811
Phone (928) 965-9889
Other practice location 1
690 E Warner Rd Ste 115
Gilbert, AZ 85296-3056
Phone (480) 444-2434
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
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-16459 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Life Counseling PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Gilbert, AZ
- NPI 1245521053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555027200000",
"number": "1114480449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 N WINDSOR",
"city": "MESA",
"state": "AZ",
"postal_code": "852136811",
"telephone_number": "928-965-9889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1234 S POWER RD STE 250",
"city": "MESA",
"state": "AZ",
"postal_code": "852063742",
"telephone_number": "602-633-5032"
}
],
"practiceLocations": [
{
"address_1": "690 E Warner Rd Ste 115",
"address_purpose": "LOCATION",
"city": "Gilbert",
"state": "AZ",
"postal_code": "852963056",
"country_code": "US",
"telephone_number": "480-444-2434",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YARDLEY",
"first_name": "BONNIE",
"middle_name": "BLEU",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-12",
"last_updated": "2019-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LAC-16459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.