Judy Mary Bonadio, LCSW
Individual provider Active NPI Clinical Social Worker · Fairfield, CT
NPI 1710044813 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1710044813
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 002484 (CT)
- Practice address
- 1305 Post Rd
Suite 206
Fairfield, CT 06824-6016 - Phone
- (203) 255-0642
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychotherapy Associates of Western Connecticut | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 002484 | CT | Yes |
Addresses
Primary practice location
1305 Post Rd
Suite 206
Fairfield, CT 06824-6016
Mailing address
1305 Post Rd
Suite 206
Fairfield, CT 06824-6016
Phone (203) 255-0642
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002484 | Other | CT | STATE LICENSE NUMBER |
Other providers in Fairfield, CT
- Robert Boback
- Ingri Boe-Wiegaard
- Nicholas S Bogannam
- Bojana Jankovic Weatherly MD of New Jersey PC
- John Scott Bomann
- Mallory Bonarrigo
- Susan R Bonato
- Kathleen R Bonaventura
- Melissa Bonilla
- Kaitlyn Boorin
All providers in Fairfield, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.