Active NPI
Katherine Bonilla
- Clinical Social Worker
- Southern Pines, NC
National Provider Identifier
1174344121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW22666
- Practice address
- 135 W Illinois Ave Unit 141
Southern Pines, NC 28387-5808 - Phone
- (786) 502-1833
- NPI assigned
- Oct 22, 2024
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW22666 | FL | Primary |
Addresses
Primary practice location
135 W Illinois Ave Unit 141
Southern Pines, NC 28387-5808
Mailing address
135 W Illinois Ave Unit 141
Southern Pines, NC 28387-5808
Phone (786) 502-1833
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 |
|---|---|---|---|
| SW22666 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1174344121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 W ILLINOIS AVE UNIT 141",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283875808",
"telephone_number": "786-502-1833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 W ILLINOIS AVE UNIT 141",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283875808",
"telephone_number": "786-502-1833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONILLA",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-22",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW22666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.