Provider Demographics
NPI:1922134006
Name:BONK-THOMSON, JANE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:BONK-THOMSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:THOMSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:700 UNIVERSE BLVD
Mailing Address - Street 2:EAP/JB
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2657
Mailing Address - Country:US
Mailing Address - Phone:561-236-1207
Mailing Address - Fax:561-691-7899
Practice Address - Street 1:700 UNIVERSE BLVD
Practice Address - Street 2:EAP/JB
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-2657
Practice Address - Country:US
Practice Address - Phone:561-236-1207
Practice Address - Fax:561-691-7899
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW2122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health