Michelle Bonilla, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

011255 Issued in NY

Practice address

401 Bloomingdale Rd
Staten Island, NY 10309-2010

Phone

(718) 300-5655

NPI assigned

Apr 29, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michellebonilla@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Shine Medical of Ca PC

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1942935473
  NPD (past)
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1497338339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 N FELTUS ST",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791245",
            "telephone_number": "908-342-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BLOOMINGDALE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092010",
            "telephone_number": "718-300-5655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1885 Hylan Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103052110",
            "country_code": "US",
            "telephone_number": "347-509-4120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "MICHELLE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Carrie Bongiovanni
• Jennifer Ellen Bonica, RPH
• Celenia Bonifacio, M.S. SPED
• Karla J Bonilla
• Lizzette Bonilla, SW- L.M.S.W.
• Mildred Pabua Bonilla, RN
• Julia Bonoan
• Marcus Salvador Bonoan, MD
• Donna Angela Bonomi, MS/PT
• Giovanni Bonomo, M.D.

• Mental Health Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Mental Health Counselor in New York

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