Organization Active NPI

Laura Bonini LCSW, PLLC

  • Clinical Social Worker
  • Norfolk, VA
National Provider Identifier
1417454646
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007040 Issued in VA
Legal business name
LAURA BONINI LCSW, PLLC
Practice address
5660 E Virginia Beach Blvd Ste 201
Norfolk, VA 23502-2468
Phone
(757) 389-1453
Fax
(866) 806-6123
NPI assigned
Apr 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Authorized official

Name
Laura Elizabeth Bonini, LCSWNPI 1134447139
Title
Therapist/Owner
Phone
(757) 389-1453

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 0904007040 VA Primary

Addresses

Primary practice location

5660 E Virginia Beach Blvd Ste 201
Norfolk, VA 23502-2468

Mailing address

1207 Dewberry Dr
Chesapeake, VA 23320-5124
Phone (757) 339-5558

Other identifiers 1

IdentifierTypeStateIssuer
VAA101568OtherVAMEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180718004168 VA Part B Supplier - Clinic/Group Practice 9032466222 Receives reassigned benefits from 1 practitioner
Practice locations: Norfolk, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1417454646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 DEWBERRY DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205124",
            "telephone_number": "757-339-5558",
            "fax_number": "866-806-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5660 E VIRGINIA BEACH BLVD STE 201",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022468",
            "telephone_number": "757-389-1453",
            "fax_number": "866-806-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA BONINI LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "BONINI",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "757-389-1453",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "VAA101568",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.