Leah Bonilla, PHD, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301018128 Issued in MI

Practice address

888 W Big Beaver Rd Ste 1450
Troy, MI 48084-4762

Phone

(248) 244-8644

NPI assigned

Oct 2, 2019

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

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Bonilla Behavioral Health, PLLC

  • Psychologist
  • North Las Vegas, NV
  • NPI 1295554210
  NPD (past) Authorized official

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1346881232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W BIG BEAVER RD STE 1450",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844762",
            "telephone_number": "248-244-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W BIG BEAVER RD STE 1450",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844762",
            "telephone_number": "248-244-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "LEAH",
        "credential": "PHD, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301018128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Conners Boncore
• Kristina J Bond, FNP
• Lori Bondalapati, MA, LPC, CAADC
• Cortney Bonello, FNP-BC
• John D Bonema, MD
• Jeremy Bonka
• Booth Counseling Services, P.C.
• Elaine Booth, LMSW
• Erica Boreczky
• Bormans Inc (Farmer Jack Pharmacy)

• Psychologist in Troy, MI
• Providers in Troy, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.