Provider Demographics
NPI:1639410731
Name:BONIER, STEPHANIE MARIE (MA, LCPC, CADC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MARIE
Last Name:BONIER
Suffix:
Gender:F
Credentials:MA, LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 FAWN RIDGE CT
Mailing Address - Street 2:UNIT B
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-9664
Mailing Address - Country:US
Mailing Address - Phone:630-464-8100
Mailing Address - Fax:
Practice Address - Street 1:907 FAWN RIDGE CT
Practice Address - Street 2:UNIT B
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-9664
Practice Address - Country:US
Practice Address - Phone:630-464-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009607101YP2500X
IL178008465101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor