Bonita Streetman, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

34002619A Issued in IN

Legal business name

BONITA STREETMAN, LLC

Practice address

2633 E 136TH St
Carmel, IN 46032-1855

Phone

(317) 446-4125

NPI assigned

Jan 14, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Bonita Lee Streetman, M.S., LCSW, LCAC

Title

Clinical Counselor

Phone

(317) 446-4125

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1484352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484352000000",
    "number": "1720524762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 DOMINION DR",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460771872",
            "telephone_number": "317-446-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 E 136TH ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321855",
            "telephone_number": "317-446-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONITA STREETMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-14",
        "last_updated": "2017-01-14",
        "status": "A",
        "authorized_official_last_name": "STREETMAN",
        "authorized_official_first_name": "BONITA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CLINICAL COUNSELOR",
        "authorized_official_telephone_number": "317-446-4125",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., LCSW, LCAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "34002619A",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "87000793A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Carmel, IN
• Providers in Carmel, IN by specialty
• Community/Behavioral Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.

Verify at the official NPI Registry.