Provider Demographics
NPI:1346952843
Name:BONES, CHARYS JULISSA
Entity Type:Individual
Prefix:
First Name:CHARYS
Middle Name:JULISSA
Last Name:BONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 WATER ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-5127
Mailing Address - Country:US
Mailing Address - Phone:978-880-1179
Mailing Address - Fax:
Practice Address - Street 1:1R NEWBURY ST STE 401
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3816
Practice Address - Country:US
Practice Address - Phone:617-804-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health