Bonnelle Rose Diaz, MS, LMHC, MHP, SUDP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60744063 Issued in WA

Practice address

12715 E Mission Ave
Spokane Valley, WA 99216-1027

Phone

(509) 232-5766

NPI assigned

Dec 4, 2017

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/spokanerecovery/r4/
• Direct secure messaging: bonnellediaz@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• American Behavioral Health Systems, Inc.

  • Substance Abuse Rehabilitation Facility
  • Chehalis, WA
  • NPI 1598123226
  NPD (past)
• American Behavioral Health Systems, Inc.

  • Substance Abuse Rehabilitation Facility
  • Spokane Valley, WA
  • NPI 1962991661
  NPD (past)
• Spokane Treatment and Recovery Services

  • Addiction (Substance Use Disorder) Counselor
  • Spokane, WA
  • NPI 1104957323
  NPD (past)

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1780199455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 N ELM ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992054135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12715 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161027",
            "telephone_number": "509-232-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "BONNELLE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "MS, LMHC, MHP, SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60744063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marvin George Deubel Jr., B.A.
• Christopher Devaney, CBT
• Antre Lamonte Devers
• Ligeia Julia Devleming, MSW, LICSW
• Heather Di Biase, MSW
• Megan Renee Diaz
• Shannon G Dibartolo, PHARMD
• Timothy Daniel Dibble, MD
• Shannon M Dickens, MSW
• Alexus Jamelia Dickerson

• Mental Health Counselor in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.