Darra Bonham, LICSW

Individual provider Active NPI Clinical Social Worker · Hibbing, MN

NPI 1740965490 · NPPES record last updated Jan 26, 2024

Key facts

NPI
1740965490
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
29469 (MN)
Practice address
2602 1St Ave
Hibbing, MN 55746-2245
Phone
(218) 263-5949
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Bonham Psychotherapy Services Clinical Current
since Dec 3, 2023
Accepting new patients
Kind Mind Counseling Center Current
since Jun 25, 2023
Accepting new patients
Calla Current
since Jun 25, 2023
Accepting new patients

Locations

2602 1st Ave
Hibbing, MN 55746
Phone (218) 203-5949

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 29469 MN Yes

Addresses

Primary practice location

2602 1St Ave
Hibbing, MN 55746-2245

Mailing address

2601 1St Ave
Hibbing, MN 55746-2244
Phone (218) 264-5949

Other providers in Hibbing, MN

All providers in Hibbing, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.