Provider Demographics
NPI:1437173002
Name:MORAN, BONNIE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:
Last Name:MORAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CREST DR
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-1308
Mailing Address - Country:US
Mailing Address - Phone:508-947-5768
Mailing Address - Fax:
Practice Address - Street 1:800 PURCHASE ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6355
Practice Address - Country:US
Practice Address - Phone:508-990-0894
Practice Address - Fax:508-990-0298
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5943101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health