Provider Demographics
NPI:1568952760
Name:BOND, WILLIE SEE (CDCA)
Entity Type:Individual
Prefix:MR
First Name:WILLIE
Middle Name:SEE
Last Name:BOND
Suffix:
Gender:M
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BOWMAN ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-1235
Mailing Address - Country:US
Mailing Address - Phone:419-525-3525
Mailing Address - Fax:419-525-3538
Practice Address - Street 1:400 BOWMAN ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-1235
Practice Address - Country:US
Practice Address - Phone:419-525-3525
Practice Address - Fax:419-525-3538
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH100488101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)