Justin John Bontke, LCSW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

64221 Issued in TX

Practice address

5106 Stoneleigh Ave
Dallas, TX 75235-8331

Phone

(214) 226-8616

NPI assigned

Nov 6, 2023

Sex

Male

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

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

Practice roles

Locations

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634
  NPD

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1285407882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 STONELEIGH AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358331",
            "telephone_number": "214-226-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5106 STONELEIGH AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358331",
            "telephone_number": "214-226-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONTKE",
        "first_name": "JUSTIN",
        "middle_name": "JOHN",
        "credential": "LCSW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonny S. Olney, D.O., P.a.
• Matthew Bonser, CRNA
• Whitney Morgan Bonser, AGACNP
• Mary L Bonsu, PSY.D
• Frances Beth Bontempo, PH.D.
• Codie Bontz, DDS, MS
• Andrea Bonzell
• Ismail Boodhwani Jr., FNP-C
• Lueretha Yvonne Booker, MA
• Shelley Booker, D.C.

• Clinical Social Worker in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.