Active NPI
Bonita Perkins
- Marriage & Family Therapist
- Newland, NC
National Provider Identifier
1588943641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1375
- Practice address
- 360 Beech St
Newland, NC 28657-9670 - Phone
- (828) 733-5889
- Fax
- (828) 733-9462
- NPI assigned
- Aug 8, 2011
- Last updated
- May 9, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1899 | NC | |
| Marriage & Family Therapist | 106H00000X | 1375 | NC | Primary |
Addresses
Primary practice location
360 Beech St
Newland, NC 28657-9670
Mailing address
284 Executive Park Dr
Suite 100
Concord, NC 28025-1833
Phone (704) 939-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106H0000X | Medicaid | NC |
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 |
|---|---|---|---|
| 1375 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 1899 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1588943641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR",
"address_2": "SUITE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 BEECH ST",
"city": "NEWLAND",
"state": "NC",
"postal_code": "286579670",
"telephone_number": "828-733-5889",
"fax_number": "828-733-9462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERKINS",
"first_name": "BONITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-08",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1899",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1375",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106H0000X",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newland, NC
- New River Service Authority (New River Behavioral HealthCare)
- Newland Operating Al, LLC (Cranberry House)
- North Carolina CVS Pharmacy LLC (CVS Pharmacy #05558)
- Amanda Lou Paramore, LCSWA, MSW
- Deborah Louise Peck, LPC
- Isabel Willard Peterson
- Kristin Langdon Phillips
- Jennifer Pierce, DMD
- Premier Pharmacy Inc
- James Patterson Pressly
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.