Bonny McBride, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S14353 Issued in TX

Practice address

702 S Palestine St
Athens, TX 75751-3325

Phone

(903) 675-9595

Fax

(903) 677-2110

NPI assigned

Jan 8, 2007

Last updated

Sep 27, 2011By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Community Counseling Center Inc

  • Clinical Social Worker
  • Athens, TX
  • NPI 1285946343
  Authorized official Same address or phone

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1972651560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2536",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757517536",
            "telephone_number": "903-675-9595",
            "fax_number": "903-677-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S PALESTINE ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757513325",
            "telephone_number": "903-675-9595",
            "fax_number": "903-677-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "BONNY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "S14353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108313102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Srikar Reddy Mapakshi, M.D.
• Lucianne Marin, M.D.
• Mark L Eldore MD PLLC (Athens Women's and Children's Center)
• Gannon Bradley Marsh, FNP
• Jasmine Martin, PHARMD
• Brenda Joy McBride, LCSW
• William A McBride, PHD
• Francine F McCain, M.D.
• Kimberly McCoy, WHCNP
• Julie Kay McIntyre, LPC

• Clinical Social Worker in Athens, TX
• Providers in Athens, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.