Provider Demographics
NPI:1912571712
Name:SUMMEY, BONNIE KATHRYN (LCMHC)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:KATHRYN
Last Name:SUMMEY
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4358
Mailing Address - Country:US
Mailing Address - Phone:704-874-1907
Mailing Address - Fax:
Practice Address - Street 1:1020 SOUTH POINT RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-8533
Practice Address - Country:US
Practice Address - Phone:704-836-9611
Practice Address - Fax:704-825-6951
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14425101YM0800X
NCA14425101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health