Colleen J Bonner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

59918 Issued in TX

Practice address

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Phone

(469) 419-3753

NPI assigned

Dec 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1477213775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 HUNTINGTON DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760107632",
            "telephone_number": "214-803-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "469-419-3753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2106 Huntington Dr",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760107632",
            "country_code": "US",
            "telephone_number": "214-803-3602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNER",
        "first_name": "COLLEEN",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF SOCIAL WORKER EXAMINERS",
            "identifier": "59918",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boniface a. Agu
• Alejandra Bonilla
• Jessica Bonilla
• Rachel Bonnema, MD
• Angelina Bonner, O.D.
• Hana Bonner
• Wilmot Vincent Bonnet, M.D.
• Anna Beth Bonney, LPC-A
• Beverly Geiger Bonnheim, MSSW
• Malcolm L Bonnheim, PH.D.

• Clinical Social Worker in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.