Pamela Ann Bonilla, LPC-21205

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-21205 Issued in AZ

Practice address

3200 N. Dobson Rd.
Suite D3
Phoenix, AZ 85014-8501

Phone

(480) 420-7514

NPI assigned

Aug 22, 2022

Last updated

Aug 22, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Compassionate Heart Christian Counseling, PLLC

  • Mental Health Counselor
  • Chandler, AZ
  • NPI 1548994270
  NPD Authorized official

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1376261677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 N VAL VISTA RD",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851198643",
            "telephone_number": "148-081-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 N. DOBSON RD.",
            "address_2": "SUITE D3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850148501",
            "telephone_number": "480-420-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC-21205",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-21205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://secure.simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "secure client portal messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "client portal",
            "address_1": "3200 N. Dobson Rd.",
            "address_2": "Suite D3",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850148501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Bonham
• Emmanuel Bonilla-Segura, PT, DPT
• Adriana A Bonilla
• Briauna Mae Bonilla
• Gabriel L Bonilla, MD
• Christopher L Bonin, D.C.
• Bonita Women's Care, P.L.C.
• Andrea N Bonk, MS, CCC-SLP
• Mary Kristine Bonn, MD
• Andrea Bonner, RBT

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.