Provider Demographics
NPI:1346287216
Name:BONACCI, LOUISE CECILIA (MSW LCSW R)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:CECILIA
Last Name:BONACCI
Suffix:
Gender:F
Credentials:MSW LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2329
Mailing Address - Country:US
Mailing Address - Phone:315-733-0520
Mailing Address - Fax:315-733-0518
Practice Address - Street 1:114 GENESEE ST
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2329
Practice Address - Country:US
Practice Address - Phone:315-733-0520
Practice Address - Fax:315-733-0518
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0729821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical