Bonnie Aaron Mervis, PH.D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149001026 Issued in IL

Practice address

70 Hastings Ave
Highland Park, IL 60035-5158

Phone

(847) 432-2113

Fax

(847) 433-3135

NPI assigned

May 31, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275264000000",
    "number": "1730408725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 CENTRAL AVE",
            "address_2": "SUITE #200",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352622",
            "telephone_number": "847-432-2113",
            "fax_number": "847-433-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 HASTINGS AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355158",
            "telephone_number": "847-432-2113",
            "fax_number": "847-433-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERVIS",
        "first_name": "BONNIE",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-31",
        "last_updated": "2010-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149001026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "149001026",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Lynn Meister, LCSW
• Keith Mellovitz, DDS
• Alison Melnick
• Jill B. Meltzer, AU.D.
• Lauren Hope Mendelson, LMT
• Helen Yafa Meyerhoff, LCPC
• Jennifer Anne Meyers, CCC-SLP
• Gail M Meyerson, RN, BSN, CDE
• Jordyn Meyerson, LPC
• Gabrielle Meza, LMT

• Clinical Social Worker in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2010; 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.