Jessica Rose Bonneville, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

3899 Okemos Rd Ste A1
Okemos, MI 48864-3666

Phone

(517) 507-5892

Fax

(517) 258-2951

NPI assigned

Jan 19, 2018

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 names 1

• Jessica Rose Mariano Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Spring Forest Counseling LLP

  • Mental Health Counselor
  • Okemos, MI
  • NPI 1841744299
  Medicare reassignment NPD
• Inclusive Wellness LLC

  • Clinical Social Worker
  • East Lansing, MI
  • NPI 1891389029
  NPD

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1578071841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N CLINTON AVE APT 5",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488791529",
            "telephone_number": "616-915-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3899 OKEMOS RD STE A1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643666",
            "telephone_number": "517-507-5892",
            "fax_number": "517-258-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEVILLE",
        "first_name": "JESSICA",
        "middle_name": "ROSE",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "MARIANO",
            "middle_name": "ROSE",
            "credential": "MA, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bold Beginnings Therapy Services LLC
• Morghan Bolden
• Misty Bond
• Sarah Rachael Bond, CLC
• Meagan Bonkowski, PHARM.D.
• Caitlin Boomer
• Cadence Borch
• Isabella Borruso
• Bosworth Urgent Care PC
• Bosworth Urgent Care, PC

• Professional Counselor in Okemos, MI
• Providers in Okemos, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.