Beverly Jean Bonnell, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CCMH0218971 Issued in NM

Practice address

707 Broadway Blvd NE
Albuquerque, NM 87102-2360

Phone

(505) 345-8471

Fax

(505) 342-5414

NPI assigned

Jun 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Pediatric and Family Care, LLCGroup PAC ID 4981917481, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDGCDA

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.

• Southwest Pediatric and Family Care, LLC

  • Primary Care Clinic/Center
  • Deming, NM
  • NPI 1881089886
  Medicare reassignment Care Compare group NPD
• Southwest Therapeutics LLC

  • Community/Behavioral Health Agency
  • Deming, NM
  • NPI 1619723426

  Professional

  NPD
• Springvale Health Centers,Inc

  • Federally Qualified Health Center (FQHC)
  • Dover, OH
  • NPI 1396577276
  NPD (past)

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1851884167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 ASH ST SW",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880300793",
            "telephone_number": "330-205-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022360",
            "telephone_number": "505-345-8471",
            "fax_number": "505-342-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNELL",
        "first_name": "BEVERLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0218971",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1700338",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Bone, PHD
• Caroline Alberta Bonham, MD
• Allean Raneta Bonin
• Bonita Wickstrom Inc
• Carlos Jacob Bonnafoux, MD MEDICAL STUDENT
• Paul Bonnell, LMSW
• Mary Kathryn Bonner, RRT
• Jana Bonnett, PHARM D
• April Bonney, LCSW
• Donald E Bonney, DC

• Professional Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.