Sharon Lee Bonnellbradley, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1024763 Issued in MA

Practice address

84 High St
Suite 2B
Medford, MA 02155-3844

Phone

(781) 391-1640

Fax

(781) 391-1640

NPI assigned

Nov 30, 2006

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 10

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366510307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 HIGH ST",
            "address_2": "SUITE 2B",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553844",
            "telephone_number": "781-391-1640",
            "fax_number": "781-391-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 HIGH ST",
            "address_2": "SUITE 2B",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553844",
            "telephone_number": "781-391-1640",
            "fax_number": "781-391-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNELLBRADLEY",
        "first_name": "SHARON",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1024763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE PROVIDER ID",
            "identifier": "550010005757",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK PROVIDER ID",
            "identifier": "986151",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP PROVIDER ID",
            "identifier": "003450",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1013390",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "7925159",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSPROVIDER ID",
            "identifier": "P07505",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER ID",
            "identifier": "003450",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBC PROVIDER ID",
            "identifier": "314436",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PROVIDER ID",
            "identifier": "793613",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851489",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer L. Bonczek, RD
• Christine M Bond-Eaves, MA CCCA A
• Abigail Bond, MHC
• Sara Ines Bonilla, LMHC, CCM
• Wayne Bonkowski, DPT
• Borrelli Counseling LLC
• Boston Behavioral Health Associates Inc
• Boston Center for Facial Aesthetics
• Boston Laser Eye Institute- Winchester LLC
• Boston Laser Medford LLC

• Mental Health Counselor in Medford, MA
• Providers in Medford, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.