Individual provider Active NPI

Trudy Bond, ED.D.

  • Counseling Psychologist
  • Toledo, OH
National Provider Identifier
1790763803
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2978 Issued in OH
Practice address
3131 Executive Pkwy
Suite 104
Toledo, OH 43606-1367
Phone
(419) 536-3356
Fax
(419) 536-9709
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 2978 OH Primary
Counseling Psychologist 103TC1900X 3786 MI

Addresses

Primary practice location

3131 Executive Pkwy
Suite 104
Toledo, OH 43606-1367

Mailing address

3131 Executive Pkwy
Suite 104
Toledo, OH 43606-1367
Phone (419) 536-3356

Other identifiers 1

IdentifierTypeStateIssuer
0454173MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121009000459 OH Practitioner - Clinical Psychologist 1456500305 Practice locations: Toledo, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3131 Executive Pkwy
Suite 104
Toledo, OH 43606-1327
Phone (419) 536-3356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3786MIMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1790763803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 EXECUTIVE PKWY",
            "address_2": "SUITE 104",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061367",
            "telephone_number": "419-536-3356",
            "fax_number": "419-536-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 EXECUTIVE PKWY",
            "address_2": "SUITE 104",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061367",
            "telephone_number": "419-536-3356",
            "fax_number": "419-536-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOND",
        "first_name": "TRUDY",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "2978",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "3786",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0454173",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.