Bonnie D Haley, LCSW R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R069491 Issued in NY

Practice address

12592 Sagewood Dr
Venice, FL 34293-0333

Phone

(631) 744-7009

NPI assigned

Aug 14, 2006

Last updated

Oct 1, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 23, 2023 through Sep 23, 2027

Medicare enrollment (NPD)

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.

• Pyschotherapy and Social Work Concepts PC

  • Clinic/Center
  • Rocky Point, NY
  • NPI 1831336759
  NPD Authorized official

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1386657963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12592 SAGEWOOD DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342930333",
            "telephone_number": "631-744-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12592 SAGEWOOD DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342930333",
            "telephone_number": "631-744-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "BONNIE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LCSW R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Hack, MS, LPC, LMHC
• Linda Susan Hahn X
• Justin Guy Haines, PMHNP
• Patricia Haines
• Issam Afif Halaby, M.D.,PH.D.
• Susan Haley, LCSW
• Vanessa Hamalian, ARNP
• Cheryl L. Hamlin, LCSW
• Hanna Hamm
• Qinghong Han, L. AC

• Clinical Social Worker in Venice, FL
• Providers in Venice, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.