| Laura Bonini Lcsw, Pllc | |
|
5660 E Virginia Beach Blvd Ste 201 Norfolk VA 23502-2468 | |
| (757) 389-1453 | |
| (866) 806-6123 |
| Full Name | Laura Bonini Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 5660 E Virginia Beach Blvd Ste 201, Norfolk, Virginia |
| Authorized Official Name and Position | Laura Elizabeth Bonini (THERAPIST/OWNER) |
| Authorized Official Contact | 7573891453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Bonini Lcsw, Pllc 1207 Dewberry Dr Chesapeake VA 23320-5124 Ph: (757) 339-5558 | Laura Bonini Lcsw, Pllc 5660 E Virginia Beach Blvd Ste 201 Norfolk VA 23502-2468 Ph: (757) 389-1453 |
| NPI Number | 1417454646 |
|---|---|
| Provider Enumeration Date | 04/13/2018 |
| Last Update Date | 04/13/2018 |
| Medicare PECOS PAC ID | 9032466222 |
|---|---|
| Medicare Enrollment ID | O20180718004168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417454646 | NPI | - | NPPES |
| VAA101568 | Other | VA | MEDICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904007040 (Virginia) | Primary |
| Provider Name | Laura E Bonini |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134447139 PECOS PAC ID: 3274657465 Enrollment ID: I20100824001200 |
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