Individual provider Active NPI

William Scott Bonacker, L.C.S.W

  • Clinical Social Worker
  • Lincoln, NE
National Provider Identifier
1932246840
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
50 Issued in NE
Practice address
1919 S 40TH St
Ste 312
Lincoln, NE 68506-5243
Phone
(402) 475-5069
Fax
(402) 475-2350
NPI assigned
Jan 31, 2007
Last updated
Apr 20, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 176 NE
Professional Counselor 101YP2500X 283 NE
Clinical Social Worker 1041C0700X 50 NE Primary

Addresses

Primary practice location

1919 S 40TH St
Ste 312
Lincoln, NE 68506-5243

Mailing address

1919 S 40TH St
Ste 312
Lincoln, NE 68506-5243
Phone (402) 475-5069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20110126000274 NE Practitioner - Clinical Social Worker 6002095924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychotherapy Associates of Lancaster County, PCGroup PAC ID 6406035328, 9 clinicians

Practice addresses (Care Compare)

1919 S 40TH St
Suite 312
Lincoln, NE 68506-5247
Phone (402) 475-5069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50NEMDAddiction (Substance Use Disorder) Counselor
176NEMDMental Health Counselor
283NEMDMental Health Counselor
816NEMDSpeech-Language Pathologist
39NEMDPerfusionist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy Associates of Lancaster County, PC Mental Health CurrentSince Jan 1, 2011 Accepting new patients
Bryan Physician Network Past Accepting new patients

Locations

1919 S 40th St
Ste 312
Lincoln, NE 68506
Phone (402) 475-5069

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1932246840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 S 40TH ST",
            "address_2": "STE 312",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065243",
            "telephone_number": "402-475-5069",
            "fax_number": "402-475-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 S 40TH ST",
            "address_2": "STE 312",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685065243",
            "telephone_number": "402-475-5069",
            "fax_number": "402-475-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONACKER",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "176",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "283",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "50",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.