Individual provider Active NPI

Bonnie Lee Braglia, LPC LMFT

  • Marriage & Family Therapist
  • Corpus Christi, TX
National Provider Identifier
1578618096
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
002914042697 Issued in TX
Practice address
6028 Ennis Joslin Rd
Corpus Christi, TX 78412-2806
Phone
(361) 774-0293
Fax
(361) 452-0029
NPI assigned
Jan 24, 2007
Last updated
Oct 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC09167 TX
Marriage & Family Therapist 106H00000X 002914042697 TX Primary

Addresses

Primary practice location

6028 Ennis Joslin Rd
Corpus Christi, TX 78412-2806

Mailing address

6028 Ennis Joslin Ave.
Corpus Christi, TX 78412-2806
Phone (361) 774-0293

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

LicenseStateTypeSpecialty
LPC09167TXMDProfessional Counselor
002914042697TXMDMarriage & Family Therapist

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1578618096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6028 ENNIS JOSLIN AVE.",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784122806",
            "telephone_number": "361-774-0293",
            "fax_number": "361-458-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6028 ENNIS JOSLIN RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784122806",
            "telephone_number": "361-774-0293",
            "fax_number": "361-452-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGLIA",
        "first_name": "BONNIE",
        "middle_name": "LEE",
        "credential": "LPC LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "LPC09167",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "002914042697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.