Louise Bonneau

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

62192 Issued in TX

Practice address

4040 State Highway 6 S Ste 200
College Station, TX 77845-8962

Phone

(979) 777-0826

NPI assigned

Feb 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 21, 2024 through Feb 21, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Edelweiss Therapy, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • College Station, TX
  • NPI 1568162329
  NPD Authorized official

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1710684683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 STATE HIGHWAY 6 S STE 210",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778451805",
            "telephone_number": "979-353-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 STATE HIGHWAY 6 S STE 200",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458962",
            "telephone_number": "979-777-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEAU",
        "first_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Morris Boley, MD
• Timothy Bolton, D.C.
• Navatha Bondalapati, MD
• James Vaull Bonds Jr., MD
• Sheila H. Bonds, M.D.
• Hayley Booker
• Kristy Lyn Booth, NP-C
• Louis Booysen
• Macy Claire Borens
• Philip Anthony Borroni

• Clinical Social Worker in College Station, TX
• Providers in College Station, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.