Shelley Galasso Bonanno & Associates, PLLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

SHELLEY GALASSO BONANNO & ASSOCIATES, PLLC

Practice address

1019 Haynes St
Birmingham, MI 48009-6779

Phone

(586) 917-4001

Fax

(586) 412-5836

NPI assigned

Feb 20, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Shelley Bonanno, LLP

Title

Owner

Phone

(586) 917-4001

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1154821783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 HAYNES ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096779",
            "telephone_number": "586-917-4001",
            "fax_number": "586-412-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 HAYNES ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096779",
            "telephone_number": "586-917-4001",
            "fax_number": "586-412-5836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11111 Hall Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Utica",
            "state": "MI",
            "postal_code": "483175799",
            "country_code": "US",
            "telephone_number": "586-907-5734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHELLEY GALASSO BONANNO & ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BONANNO",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-917-4001",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LLP"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.