Heather Jo Bonitz-Moore, ATR-BC, LPC, IMH-E

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001445 Issued in CT

Practice address

46 Lebanon Rd
Bozrah, CT 06334-1116

Phone

(860) 617-4082

Fax

(860) 617-4082

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

Yes

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.

• Sacred Space Counseling and Wellness LLC

  • Professional Counselor
  • Bozrah, CT
  • NPI 1093223976

  Professional

  NPD (past) Authorized official
• Connections Counseling Center, LLC

  • Psychiatry Physician
  • Waterford, CT
  • NPI 1114069663
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821165788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FOWLER RD",
            "city": "LEBANON",
            "state": "CT",
            "postal_code": "062492503",
            "telephone_number": "860-617-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 LEBANON RD",
            "city": "BOZRAH",
            "state": "CT",
            "postal_code": "063341116",
            "telephone_number": "860-617-4082",
            "fax_number": "860-617-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "163 Boston Post Rd",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "CT",
            "postal_code": "063852809",
            "country_code": "US",
            "telephone_number": "860-444-8774",
            "fax_number": "860-444-8776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONITZ-MOORE",
        "first_name": "HEATHER",
        "middle_name": "JO",
        "credential": "ATR-BC, LPC, IMH-E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004271433",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lane Aprn, L.L.C.
• Amanda Marie Antonino, APRN
• Alane M Apicelli, RDN, CDN
• Romina Badal, DMD
• Elaine Bentley Baughn, LMFT
• Bozrah Volunteer Fire Company Inc
• Alexandra V Brennan, DMD
• Hannah Carey
• CH Specialty Services CT PLLC
• Children'S Dental Associates of NLC, PC

• All providers in Bozrah, CT
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.