Provider Demographics
NPI:1235443490
Name:BONNIE BHATTI PHD LICSW LLC
Entity Type:Organization
Organization Name:BONNIE BHATTI PHD LICSW LLC
Other - Org Name:BONNIE BHATTI PHD LICSW
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LICSW
Authorized Official - Phone:425-825-9992
Mailing Address - Street 1:11416 SLATER AVE NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8827
Mailing Address - Country:US
Mailing Address - Phone:425-825-9992
Mailing Address - Fax:425-823-2340
Practice Address - Street 1:11416 SLATER AVE NE
Practice Address - Street 2:SUITE 100
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8827
Practice Address - Country:US
Practice Address - Phone:425-825-9992
Practice Address - Fax:425-823-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000050141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty