Provider Demographics
NPI:1710944004
Name:KNOBEL, BONNEY J (LPC)
Entity Type:Individual
Prefix:
First Name:BONNEY
Middle Name:J
Last Name:KNOBEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SOUTHPOINTE CT
Mailing Address - Street 2:STE 185
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3897
Mailing Address - Country:US
Mailing Address - Phone:719-634-3777
Mailing Address - Fax:719-527-1101
Practice Address - Street 1:620 SOUTHPOINTE CT
Practice Address - Street 2:STE 185
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3897
Practice Address - Country:US
Practice Address - Phone:719-634-3777
Practice Address - Fax:719-527-1101
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3961101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional