Individual provider Active NPI

Bonnie Lynn Hennig-Trestman, LCSW

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1265957591
Registry record updated Feb 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0104010122 Issued in VA
Practice address
3 Riverside Cir
Roanoke, VA 24016-4955
Phone
(540) 224-5170
NPI assigned
Aug 8, 2017
Last updated
Feb 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 002932 CT
Clinical Social Worker 1041C0700X 0104010122 VA Primary

Addresses

Primary practice location

3 Riverside Cir
Roanoke, VA 24016-4955

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other names 1

  • Bonnie Lynn Hennig Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190924001114 VA Practitioner - Clinical Social Worker 4688904329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002932CTMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Sep 30, 2019 Accepting new patients
Carilion Medical Center CurrentSince Sep 30, 2019 Accepting new patients

Locations

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

3 Riverside Cir
Roanoke, VA 24016

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1265957591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-224-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNIG-TRESTMAN",
        "first_name": "BONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "002932",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0104010122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "HENNIG",
            "middle_name": "LYNN",
            "credential": "DSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.