Provider Demographics
NPI:1437434438
Name:DOOLEY, BONNIE S (MA, LLPC, SCL)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:S
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:MA, LLPC, SCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20960 KELLY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3137
Mailing Address - Country:US
Mailing Address - Phone:586-585-1955
Mailing Address - Fax:586-585-1963
Practice Address - Street 1:20960 KELLY RD
Practice Address - Street 2:SUITE B
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3137
Practice Address - Country:US
Practice Address - Phone:586-585-1955
Practice Address - Fax:586-585-1963
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012066101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor