Darra Bonham, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29469 Issued in MN

Practice address

2602 1St Ave
Hibbing, MN 55746-2245

Phone

(218) 263-5949

NPI assigned

Jun 20, 2023

Last updated

Jan 26, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bonham Psychotherapy Services

  • Clinical Social Worker
  • Grand Rapids, MN
  • NPI 1457127722
  NPD Authorized official
• Calla

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia, MN
  • NPI 1649791047
  NPD
• Kind Mind Counseling Center

  dba Marmie Jotter LICSW

  • Community/Behavioral Health Agency
  • Hibbing, MN
  • NPI 1528327970
  NPD

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1740965490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 1ST AVE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462244",
            "telephone_number": "218-264-5949",
            "fax_number": "218-265-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 1ST AVE",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557462245",
            "telephone_number": "218-263-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONHAM",
        "first_name": "DARRA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Marie Bigelow
• Bio-Medical Applications of Minnesota, Inc. (Fresenius Medical Care of Hibbing)
• Christopher Brian Bisping, PHARMD
• Michael Boerner, MD
• William John Bonach, RPH
• Bosh Inc (Ortonville Chiropractic Clinic)
• Allison Margaret Bottoms
• Steven Eldor Breitbarth, M. DIV. - LMFT
• Brenda Gargano (Aspen Grove Alternative Senoir Living)
• Lori Broich, LSW

• Clinical Social Worker in Hibbing, MN
• Providers in Hibbing, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.