Beronica Bonilla, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18092 Issued in MD

Practice address

604 Solarex CT Unit 201
Frederick, MD 21703-8655

Phone

(301) 663-8263

Fax

(301) 682-5326

NPI assigned

Jun 26, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Way Station Inc

  • Multi-Specialty Clinic/Center
  • Columbia, MD
  • NPI 1104914464
  NPD (past)

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1255695110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 NORTH CHARLES ST.",
            "address_2": "CREDENTIALING-CARLA CASH",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "443-761-5294",
            "fax_number": "434-420-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SOLAREX CT UNIT 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038655",
            "telephone_number": "301-663-8263",
            "fax_number": "301-682-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "BERONICA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "18092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camerica S. Boma, CRNA
• Alison Jean Bomba, PSY.D.
• Stefani Bon, LCPC, NCC
• Melissa Jolene Bondoc
• Krystle Bonet
• Helen Bonilla
• Daniel Charles Bonnette, PT
• Veronica Marie Bonsby
• Shermaine Danielle Booker, CMA, CPT, CPRP
• Dinesh Boppana, DMD

• Clinical Social Worker in Frederick, MD
• Providers in Frederick, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.