Joseph Bonnell, LPC, CADC 3

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C5095 Issued in OR

Practice address

1132 SW 13TH Ave
Portland, OR 97205-1703

Phone

(503) 267-2127

NPI assigned

Mar 10, 2015

Last updated

Jan 14, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1750774048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051703",
            "telephone_number": "503-267-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051703",
            "telephone_number": "503-267-2127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13108 NE Schuyler St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972302244",
            "country_code": "US",
            "telephone_number": "405-370-4502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNELL",
        "first_name": "JOSEPH",
        "credential": "LPC, CADC 3",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-10",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "15-05-06",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "18-02-29",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5095",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500181599",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Mulloy Bonilla, M.ED.
• Tony Leonard Bonillo, R.PH.
• Kerry Bonin
• Teresa Bonn
• Ashley Bonnefin, PA-C
• Andrew D. Bonner, ND
• Donald Bonner
• Jessica Dena Bonner
• Svetlana Bonner, M.D.
• Aimee Bonneval

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; 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.