Provider Demographics
NPI:1417597543
Name:SPALLINGER, BONNIE K (LMHC)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:K
Last Name:SPALLINGER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 S STATE ROAD 1
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-9698
Mailing Address - Country:US
Mailing Address - Phone:260-307-5030
Mailing Address - Fax:260-824-8445
Practice Address - Street 1:2350 S STATE ROAD 1
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-9698
Practice Address - Country:US
Practice Address - Phone:260-307-5030
Practice Address - Fax:260-824-8445
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003642A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health