Christopher Omar Bonilla, MSW, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P017752 Issued in NC

Practice address

1909 J N Pease PL Ste 101
Charlotte, NC 28262-4509

Phone

(980) 621-8401

NPI assigned

Jul 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: christopher.bonilla.1@12871.direct.athenahealth.com

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1891428918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BROOKRUN DR APT 1313",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092944",
            "telephone_number": "704-648-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 J N PEASE PL STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624509",
            "telephone_number": "980-621-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "CHRISTOPHER",
        "middle_name": "OMAR",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elhanan Jerahmeel Bone, LMSW, LCSWA
• Joshua Richard Bone, PSS, CADC-R
• Tyshawna Boney
• Kristen Elena Bonghi, COTA/L
• Mackenzie Brannon Bonilla Reyes, PA-C
• David Bonilla, LA.C
• Michael Robert Bonisa, PA-C
• Bonita Hutchinson and Associates, PLLC
• Alexandra Chere-Trina Bonner, LCSW-A
• Christina M Bonner, LMBT, CBS

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.