Kaitlyn Abigail Bonner

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8763 Issued in OK

Practice address

620 NW 5TH St Ste D
Moore, OK 73160-3947

Phone

(405) 208-4469

NPI assigned

Aug 29, 2022

Last updated

Aug 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kaitlyn Lewis Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Therapy Solutions of Oklahoma, LLC

  • Community/Behavioral Health Agency
  • Moore, OK
  • NPI 1659855278
  NPD

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1316667645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20711 JUANITA LN",
            "city": "TECUMSEH",
            "state": "OK",
            "postal_code": "748735325",
            "telephone_number": "325-513-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NW 5TH ST STE D",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603947",
            "telephone_number": "405-208-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "KAITLYN",
        "middle_name": "ABIGAIL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "8763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.itsofok.com",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Integrated Therapy Solutions of Oklahoma, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "620 NW 5th St Ste D",
            "city": "Moore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731603947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "LEWIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Moore, OK
• Providers in Moore, OK by specialty
• Clinical Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.