Deidre Bonarrigo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

33116 Issued in MN

Practice address

101 Dolores Ter N
North Syracuse, NY 13212-3503

Phone

(315) 451-4076

NPI assigned

Aug 8, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1396092458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5436",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132205436",
            "telephone_number": "315-451-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DOLORES TER N",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123503",
            "telephone_number": "315-451-4076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONARRIGO",
        "first_name": "DEIDRE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC22240",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06240400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12027",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081413-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "33116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jami Lee Bisesi, L.M.T.
• James J Blenn, R.PH
• Louise Paguette Blujus, LMSW, CASAC
• Mary Elizabeth Boevin, PHARM.D.
• Nicole Bogan, LPN
• Alexis Marie Borczuk
• Mary Botsford, N.P.
• Sarah Diane Bowers, LCSW-R
• Amy Lynn Branshaw
• David Brennan, DPT

• Clinical Social Worker in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.