Provider Demographics
NPI:1659022655
Name:BONACCI, BRIANNA LYNN (LPCC)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
Last Name:BONACCI
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25816 ROYALTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA STATION
Mailing Address - State:OH
Mailing Address - Zip Code:44028-9441
Mailing Address - Country:US
Mailing Address - Phone:216-375-2526
Mailing Address - Fax:
Practice Address - Street 1:215 W BOWERY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1069
Practice Address - Country:US
Practice Address - Phone:330-543-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801230101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health