Kelsey C Bonney
Individual provider Active NPI Marriage & Family Therapist · Madison, WI
NPI 1386577955 · NPPES record last updated Jun 4, 2026
Key facts
- NPI
- 1386577955
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 1228-228 (WI)
- Practice address
- 2010 Eastwood Dr Ste 102
Madison, WI 53704-5387 - Phone
- (608) 291-3676
- Fax
- (608) 716-3156
- NPI assigned
- Jun 4, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1228-228 | WI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manifest Wellness, LLC | Marriage & Family Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1228-228 | WI | Yes |
Addresses
Primary practice location
2010 Eastwood Dr Ste 102
Madison, WI 53704-5387
Mailing address
2010 Eastwood Dr Ste 102
Madison, WI 53704-5387
Phone (608) 291-3676
Other providers in Madison, WI
- Alexis Bonilla
- Bethe E. Bonk
- Nicole A Bonk
- Jane K Bonlender
- Autumn Bonner
- John David Bonsett-Veal
- Jack Scott Bontekoe
- Kathryn Denise Boomer
- Megan Lee Boone
- Stephen M Boorstein
All providers in Madison, WI · Marriage & Family Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.