Individual provider Active NPI

Bonnie Stephenson, LMHC

  • Mental Health Counselor
  • Port Orange, FL
National Provider Identifier
1811122583
Registry record updated May 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH2984 Issued in FL
Practice address
209 Dunlawton Ave
16
Port Orange, FL 32127-4472
Phone
(386) 689-2283
NPI assigned
May 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH2984 FL Primary

Addresses

Primary practice location

209 Dunlawton Ave
16
Port Orange, FL 32127-4472

Mailing address

2700 N Peninsula Ave Apt 221
New Smyrna Beach, FL 32169-2091
Phone (386) 689-2283

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH2984FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1243036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243036800000",
    "number": "1811122583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N PENINSULA AVE APT 221",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321692091",
            "telephone_number": "386-689-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 DUNLAWTON AVE",
            "address_2": "16",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274472",
            "telephone_number": "386-689-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "BONNIE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-23",
        "last_updated": "2009-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH2984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2009; 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.