Bonita Tyndall Cooley, MED, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2992 Issued in NC

Practice address

696 N Spence Ave Ste B
Goldsboro, NC 27534-4354

Phone

(919) 583-8448

Fax

(919) 583-8449

NPI assigned

May 21, 2007

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 Education

State licenses

Practice roles

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.

• Wellsprings Center of Goldsboro,P.a.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Goldsboro, NC
  • NPI 1023096088
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801005459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 N SPENCE AVE STE B",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344354",
            "telephone_number": "919-583-8448",
            "fax_number": "919-583-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 N SPENCE AVE STE B",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344354",
            "telephone_number": "919-583-8448",
            "fax_number": "919-583-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY",
        "first_name": "BONITA",
        "middle_name": "TYNDALL",
        "name_prefix": "Mrs.",
        "credential": "MED, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Phillip Conti, D.O.
• Continuum II Home Health & Hospice, Inc.
• Carolyn R. Cook, PH.D.
• Marilue M Cook, MD
• Richard Thomas Cooke, DDS, MS
• Ashton Mudd Cooper, MS, RD, LDN
• Autumn Cooper, LCSWA
• Kareem Charles Cooper, MD
• Coor'S Pharmacy, Inc
• Carrie A. Copeland, CNM-MSN

• Mental Health Counselor in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.