Provider Demographics
NPI:1346695657
Name:SIMERLY, BONNIE (LCSW)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:SIMERLY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 L AND A RD STE 204
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6276
Mailing Address - Country:US
Mailing Address - Phone:504-832-5123
Mailing Address - Fax:504-832-5133
Practice Address - Street 1:1616 L AND A RD STE 204
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6276
Practice Address - Country:US
Practice Address - Phone:504-832-5123
Practice Address - Fax:504-832-5133
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA23761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical