Jane M Bonifas, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5315 Issued in OH

Practice address

13731 Converse Roselm Rd
Venedocia, OH 45894-9532

Phone

(419) 695-2194

NPI assigned

Dec 6, 2005

Last updated

Jan 3, 2012By 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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Alternative Behavioral Services LTD

  • Psychologist
  • Lima, OH
  • NPI 1780715334
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Senior Psychological Services, Inc.

  dba Senior Psychological Associates

  • Clinical Psychologist
  • Uniontown, OH
  • NPI 1720174956
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1326022963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13731 CONVERSE ROSELM RD",
            "city": "VENEDOCIA",
            "state": "OH",
            "postal_code": "458949532",
            "telephone_number": "419-695-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13731 CONVERSE ROSELM RD",
            "city": "VENEDOCIA",
            "state": "OH",
            "postal_code": "458949532",
            "telephone_number": "419-695-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIFAS",
        "first_name": "JANE",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2054360",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM RR",
            "identifier": "680012644",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tobias Bernard Adkins, LPCC

• Psychologist in Venedocia, OH
• Providers in Venedocia, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.