Provider Demographics
NPI:1053477471
Name:BONNASUE, BONNA (LPC)
Entity Type:Individual
Prefix:DR
First Name:BONNA
Middle Name:
Last Name:BONNASUE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BREMO RD
Mailing Address - Street 2:STE 105
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2440
Mailing Address - Country:US
Mailing Address - Phone:804-282-8332
Mailing Address - Fax:804-288-4558
Practice Address - Street 1:2000 BREMO RD
Practice Address - Street 2:STE 105
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2440
Practice Address - Country:US
Practice Address - Phone:804-282-8332
Practice Address - Fax:804-288-4558
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALPC0701002351101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor