Provider Demographics
NPI:1467859793
Name:LANSING, BONNIE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:LANSING
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:LANSING-SEAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:617 N GENDALE AVENUE
Mailing Address - Street 2:BEHAVIORAL HEALTH ADULT PROGRAM
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61603
Mailing Address - Country:US
Mailing Address - Phone:309-624-9838
Mailing Address - Fax:
Practice Address - Street 1:617 N GENDALE AVENUE
Practice Address - Street 2:BEHAVIORAL HEALTH ADULT PROGRAM
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603
Practice Address - Country:US
Practice Address - Phone:309-624-9838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional