Donald Lewis Bohannon, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701007233 Issued in VA

Practice address

10712 Ballantraye Dr
Fredericksburg, VA 22407-4702

Phone

(928) 628-8517

Fax

(928) 502-1926

NPI assigned

Sep 9, 2017

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1504915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504915200000",
    "number": "1497274534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 BASALT DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224067229",
            "telephone_number": "928-502-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10712 BALLANTRAYE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074702",
            "telephone_number": "928-628-8517",
            "fax_number": "928-502-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "DONALD",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-09",
        "last_updated": "2017-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Fredericksburg, VA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2017; 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.