Provider Demographics
NPI:1245745397
Name:COLEMAN, BONNIE GIVEN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:GIVEN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CLOCK TOWER PL STE E208
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8790
Mailing Address - Country:US
Mailing Address - Phone:831-277-4862
Mailing Address - Fax:
Practice Address - Street 1:200 CLOCK TOWER PL STE E208
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8790
Practice Address - Country:US
Practice Address - Phone:831-277-4862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104290106H00000X
101YM0800X
CA124100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health