Active NPI
Bonita M Pearsall, ACSW LCSW
- Clinical Social Worker
- Media, PA
National Provider Identifier
1487779070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW012579
- Practice address
- 36 E Frront St
Media, PA 19063 - Phone
- (610) 566-9114
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW012579 | PA | Primary |
Addresses
Primary practice location
36 E Frront St
Media, PA 19063
Mailing address
630 N Lemon St
Media, PA 19063
Phone (610) 566-9114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 542733 | Other | VALUE OPTIONS |
Other names 1
- Ms. Bonita M Boyer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW012579 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487779070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 N LEMON ST",
"city": "MEDIA",
"state": "PA",
"postal_code": "19063",
"telephone_number": "610-566-9114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 E FRRONT ST",
"city": "MEDIA",
"state": "PA",
"postal_code": "19063",
"telephone_number": "610-566-9114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSALL",
"first_name": "BONITA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "ACSW LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW012579",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "542733",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BONITA",
"last_name": "BOYER",
"middle_name": "M",
"prefix": "MS.",
"credential": "ACSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.