| Bonnie Lungren Llc | |
|
315 Winding River Ln Ste 201 Charlottesville VA 22911-3568 | |
| (434) 962-8447 | |
| Not Available |
| Full Name | Bonnie Lungren Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 315 Winding River Ln Ste 201, Charlottesville, Virginia |
| Authorized Official Name and Position | Bonnie Lungren (LCSW) |
| Authorized Official Contact | 4349628447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonnie Lungren Llc 315 Winding River Ln Ste 201 Charlottesville VA 22911-3568 Ph: () - | Bonnie Lungren Llc 315 Winding River Ln Ste 201 Charlottesville VA 22911-3568 Ph: (434) 962-8447 |
| NPI Number | 1609246974 |
|---|---|
| Provider Enumeration Date | 09/30/2015 |
| Last Update Date | 09/30/2015 |
| Medicare PECOS PAC ID | 1759691587 |
|---|---|
| Medicare Enrollment ID | O20151106002400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609246974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904007809 (Virginia) | Primary |
| Provider Name | Bonnie L Lungren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144599010 PECOS PAC ID: 3577873306 Enrollment ID: I20151106002421 |
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