Provider Demographics
NPI:1437304086
Name:SEIDER, BONNIE RHONA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:RHONA
Last Name:SEIDER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:BONNIE
Other - Middle Name:RHONA
Other - Last Name:ATLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:184 BROOKLINE STREET
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492
Mailing Address - Country:US
Mailing Address - Phone:781-444-0049
Mailing Address - Fax:
Practice Address - Street 1:184 BROOKLINE STREET
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492
Practice Address - Country:US
Practice Address - Phone:781-444-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1031561104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical