Provider Demographics
NPI:1477619401
Name:DEWAR, BONNIE J (MA,LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:J
Last Name:DEWAR
Suffix:
Gender:F
Credentials:MA,LMHC, NCC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:923 DEL PRADO BLVD S
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3652
Mailing Address - Country:US
Mailing Address - Phone:239-242-6388
Mailing Address - Fax:239-242-6389
Practice Address - Street 1:923 DEL PRADO BLVD S
Practice Address - Street 2:SUITE 205
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3652
Practice Address - Country:US
Practice Address - Phone:239-242-6388
Practice Address - Fax:239-242-6389
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 3586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6489OtherBLUE CROSS BLUE SHIELD
FL489379OtherVALUE OPTIONS
FL87726OtherUNITED HEALTH CARE