Provider Demographics
NPI:1578009908
Name:BONNA LYNN HOROVITZ, LCSW, PLLC
Entity Type:Organization
Organization Name:BONNA LYNN HOROVITZ, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BONNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOROVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-605-2672
Mailing Address - Street 1:8 HIGH MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-5331
Mailing Address - Country:US
Mailing Address - Phone:845-294-5131
Mailing Address - Fax:845-294-0742
Practice Address - Street 1:106 STAGE RD
Practice Address - Street 2:FLOOR 2
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3551
Practice Address - Country:US
Practice Address - Phone:845-605-2672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0841384261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health