Provider Demographics
NPI:1174029920
Name:STOGNER, BONNIE (LPC)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:STOGNER
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 1:20 FIRTH LN
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1650
Mailing Address - Country:US
Mailing Address - Phone:757-269-1759
Mailing Address - Fax:
Practice Address - Street 1:33117 HARVEST DR
Practice Address - Street 2:
Practice Address - City:CARRSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23315-2122
Practice Address - Country:US
Practice Address - Phone:757-269-1759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69339101Y00000X
KY240237101Y00000X
VA0701007013101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor