Active NPI
Judith Michele Bonney, MSW
- Clinical Social Worker
- Saint Charles, MO
National Provider Identifier
1639343593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 22 Portwest CT
Saint Charles, MO 63303-5985 - Phone
- (636) 916-0022
- Fax
- (636) 916-0023
- NPI assigned
- Apr 22, 2008
- Last updated
- Apr 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MO | Primary |
Addresses
Primary practice location
22 Portwest CT
Saint Charles, MO 63303-5985
Mailing address
22 Portwest CT
Saint Charles, MO 63303-5985
Phone (636) 916-0022
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four Roses LLC | Past | Accepting new patients |
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": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1639343593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 PORTWEST CT",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035985",
"telephone_number": "636-916-0022",
"fax_number": "636-916-0023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 PORTWEST CT",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035985",
"telephone_number": "636-916-0022",
"fax_number": "636-916-0023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNEY",
"first_name": "JUDITH",
"middle_name": "MICHELE",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-22",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.