Nicole Bonifas, PLMHP

Individual provider Active NPI Mental Health Counselor · Elkhorn, NE

NPI 1801253166 · NPPES record last updated Jan 18, 2016

Key facts

NPI
1801253166
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
10750 (NE)
Practice address
20275 Honeysuckle Dr
Ste 103
Elkhorn, NE 68022-3962
Phone
(402) 933-5700
Fax
(402) 933-9998
NPI assigned
Jan 18, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
10750NEMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10750 NE Yes

Addresses

Primary practice location

20275 Honeysuckle Dr
Ste 103
Elkhorn, NE 68022-3962

Mailing address

20275 Honeysuckle Dr
Ste 103
Elkhorn, NE 68022-3962
Phone (402) 933-5700

Other providers in Elkhorn, NE

All providers in Elkhorn, NE · Mental Health Counselor in Nebraska

Sources for this page

Verify at the official NPI Registry.