Nicole Raastad Bonham, MA | |
109 W Watauga Ave, Johnson City, TN 37604-5621 | |
(423) 232-2600 | |
(423) 467-3644 |
Full Name | Nicole Raastad Bonham |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 109 W Watauga Ave, Johnson City, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336572981 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 3525 (Tennessee) | Primary |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
Entity Name | Frontier Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720147408 PECOS PAC ID: 2860302320 Enrollment ID: O20040109000560 |
Mailing Address | Practice Location Address |
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Nicole Raastad Bonham, MA 1167 Spratlin Park Dr, Po Box 9054, Gray, TN 37615-6205 Ph: (423) 467-3600 | Nicole Raastad Bonham, MA 109 W Watauga Ave, Johnson City, TN 37604-5621 Ph: (423) 232-2600 |
Mrs. Vicki Marie Britton, B.S Counselor Medicare: Not Enrolled in Medicare Practice Location: 3915 Bristol Hwy, Suite 202, Johnson City, TN 37601 Phone: 423-283-6556 Fax: 423-283-6550 | |
Hayley Christian Henderson, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 West Watauga Avenue, Watauga C&y, Johnson City, TN 37604 Phone: 423-232-2600 Fax: 423-467-3644 | |
Matthew M Midkiff, LPC, MHSP Counselor Medicare: Medicare Enrolled Practice Location: 109 W Watauga Ave, Johnson City, TN 37604 Phone: 423-232-2600 Fax: 423-467-3644 | |
Neil Stoltzfus, Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 W Oakland Ave Ste 202, Johnson City, TN 37604 Phone: 423-850-1150 | |
Michael Arthur Benoit, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3915 Bristol Hwy, Suite 202, Johnson City, TN 37601 Phone: 423-283-6500 Fax: 423-283-6550 | |
Dr. Nicholas Porta, PSYD Counselor Medicare: Medicare Enrolled Practice Location: 2514 1/2 Wesley St Ste 2, Johnson City, TN 37601 Phone: 423-529-0385 Fax: 423-414-2699 | |
Jessica Cabe, LPC-MHSP Counselor Medicare: Medicare Enrolled Practice Location: 3114 Browns Mill Rd, Johnson City, TN 37604 Phone: 423-631-0432 |