Mary Evelyn Bonds, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L2595 Issued in OR

Practice address

965 Liberty St SE
Salem, OR 97302-4138

Phone

(503) 588-2004

Fax

(503) 588-2415

NPI assigned

Jul 24, 2006

Sex

Female

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

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Breaking Free, LLC

  • Community/Behavioral Health Agency
  • Lebanon, OR
  • NPI 1629575212
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962424424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024138",
            "telephone_number": "503-588-2004",
            "fax_number": "503-588-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024138",
            "telephone_number": "503-588-2004",
            "fax_number": "503-588-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONDS",
        "first_name": "MARY",
        "middle_name": "EVELYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L2595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Larance Bonar, DMD
• Victoria A Bonar, DMD
• Bonaventure Place Retirement & Assisted Living Community LLC
• Sarah Bond
• Searainya Bond, MFT
• Alicia Bone Bone, LPC
• Beyounka Bonner
• Megan Bonner, RDH
• Subrena Ann Bons, LCSW
• Boone Road Senior Living LLC

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.