Colleen Myers Bonadio, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1192 Issued in TN

Practice address

5350 Poplar Ave Ste 730
Memphis, TN 38119-3697

Phone

(901) 683-5658

Fax

(901) 684-1277

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Methodist Healthcare

  • Adolescent and Children Mental Health Clinic/Center
  • Memphis, TN
  • NPI 1164540084
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154547636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 POPLAR AVE STE 730",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193697",
            "telephone_number": "901-683-5658",
            "fax_number": "901-684-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 POPLAR AVE STE 730",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193697",
            "telephone_number": "901-683-5658",
            "fax_number": "901-684-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONADIO",
        "first_name": "COLLEEN",
        "middle_name": "MYERS",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "1192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell L Bolyard, PSY.D.
• Allison L Bomar-Hyong, DC
• Susan A Bomar, MA
• Kavita Bomb, MD
• Ritin Bomb, MD
• Kenneth Owura Bonaparte, M.D
• Ashley Lynn Bond, DPT
• Keven Scott Bond, CFO
• Bonds Care Home, Inc #2
• Dorian Darnell Bonds Sr.

• Professional Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.