Individual provider Active NPI

Bonnie Hall-Polus, PHD

  • Counseling Psychologist
  • Lexington, KY
National Provider Identifier
1629080379
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
960 Issued in KY
Practice address
535 W 2ND St
Ste 207
Lexington, KY 40508-9002
Phone
(859) 255-4864
Fax
(859) 255-5385
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 960 KY Primary

Addresses

Primary practice location

535 W 2ND St
Ste 207
Lexington, KY 40508-9002

Mailing address

535 W 2ND St
Ste 207
Lexington, KY 40508-9002
Phone (859) 255-4864

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
960KYMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629080379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W 2ND ST",
            "address_2": "STE 207",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405089002",
            "telephone_number": "859-255-4864",
            "fax_number": "859-255-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W 2ND ST",
            "address_2": "STE 207",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405089002",
            "telephone_number": "859-255-4864",
            "fax_number": "859-255-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL-POLUS",
        "first_name": "BONNIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "KY",
            "license": "960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.