Provider Demographics
NPI:1558482307
Name:DOCKERY, BONNIE CELESTE (LCSW, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:CELESTE
Last Name:DOCKERY
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E MOORE AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-3204
Mailing Address - Country:US
Mailing Address - Phone:800-697-4296
Mailing Address - Fax:972-551-2927
Practice Address - Street 1:102 E MOORE AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-3204
Practice Address - Country:US
Practice Address - Phone:800-697-4296
Practice Address - Fax:972-551-2927
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187351041C0700X
TX3305106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist