Louis Jason Bonfanti II, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1820 Issued in LA

Practice address

109 Yorktown Dr
Suite B
Alexandria, LA 71303-3621

Phone

(318) 487-9895

Fax

(318) 767-3339

NPI assigned

Jun 3, 2006

Last updated

Jun 27, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1871531582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 YORKTOWN DR",
            "address_2": "SUITE B",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033621",
            "telephone_number": "318-487-9895",
            "fax_number": "318-767-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 YORKTOWN DR",
            "address_2": "SUITE B",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033621",
            "telephone_number": "318-487-9895",
            "fax_number": "318-767-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFANTI",
        "first_name": "LOUIS",
        "middle_name": "JASON",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "1820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1655627",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evelyn Gail Blue, LPN
• BMS Wellness
• Velva Boles, M.D.
• Shane Bolton
• Valerie Bolton, PNP
• Jerry Paul Bonial
• Morgan Brame Bonial, NP
• Madeline Taylor Bonnette, PA-C
• Jay O Book, NP
• Courtney Laine Booker

• Clinical Social Worker in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.