Provider Demographics
NPI:1821219882
Name:CRIPE, BONNIE SUE (PHD LMSW ACSW DAPA)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:SUE
Last Name:CRIPE
Suffix:
Gender:F
Credentials:PHD LMSW ACSW DAPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18554 NORTHLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-8788
Mailing Address - Country:US
Mailing Address - Phone:231-592-8090
Mailing Address - Fax:231-796-3184
Practice Address - Street 1:18554 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-8788
Practice Address - Country:US
Practice Address - Phone:231-592-8090
Practice Address - Fax:231-796-3184
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010351891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical