Provider Demographics
NPI:1053506022
Name:MORISETTE-HOOD, BONITA SUE (MSW, LCSW-1619)
Entity Type:Individual
Prefix:MS
First Name:BONITA
Middle Name:SUE
Last Name:MORISETTE-HOOD
Suffix:
Gender:F
Credentials:MSW, LCSW-1619
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3019 CABIN CREEK PL
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-3672
Mailing Address - Country:US
Mailing Address - Phone:307-258-0925
Mailing Address - Fax:
Practice Address - Street 1:5000 BLACKMORE RD
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609
Practice Address - Country:US
Practice Address - Phone:307-233-6000
Practice Address - Fax:307-233-6089
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1619101YM0800X
WY4621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health