Provider Demographics
NPI:1609382761
Name:AMES, BONNIE JORDAN (LCSW)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:JORDAN
Last Name:AMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N PLAZA EAST BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2806
Mailing Address - Country:US
Mailing Address - Phone:812-413-0315
Mailing Address - Fax:812-909-3001
Practice Address - Street 1:101 N PLAZA EAST BLVD STE 230
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2806
Practice Address - Country:US
Practice Address - Phone:812-413-0315
Practice Address - Fax:812-909-3001
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33008087A104100000X
IN34008472A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker