Provider Demographics
NPI:1619008570
Name:KLINGINSMITH, BONITA LOUISE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:BONITA
Middle Name:LOUISE
Last Name:KLINGINSMITH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 BAYRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2014
Mailing Address - Country:US
Mailing Address - Phone:352-686-0370
Mailing Address - Fax:
Practice Address - Street 1:4384 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1965
Practice Address - Country:US
Practice Address - Phone:352-683-2362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health