Individual provider Active NPI

Bonita Edmondson, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1861287377
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3039 Issued in KY
Practice address
3430 Newburg Rd Ste 210
Louisville, KY 40218-2458
Phone
(502) 454-8800
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 168832 KY
Clinical Social Worker 1041C0700X 3039 KY Primary

Addresses

Primary practice location

3430 Newburg Rd Ste 210
Louisville, KY 40218-2458

Mailing address

3711 Cutler Rd
Louisville, KY 40219-3711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20250926001187 KY Practitioner - Clinical Social Worker 0840795126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisville Behavioral Health Systems PLLCGroup PAC ID 1759378946, 11 clinicians

Practice addresses (Care Compare)

3430 Newburg Rd
Suite 210
Louisville, KY 40218-2458
Phone (502) 454-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
168832KYMDAddiction (Substance Use Disorder) Counselor
3039KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Louisville Behavioral Health Systems PLLC Clinical CurrentSince Aug 19, 2025 Accepting new patients
Dr Charles Bensenhaver III LLC CurrentSince Apr 20, 2025 Accepting new patients

Locations

3430 Newburg Rd
Ste 210
Louisville, KY 40218
Phone (502) 225-4900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1861287377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 CUTLER RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 NEWBURG RD STE 210",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182458",
            "telephone_number": "502-454-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "BONITA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "168832",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.