Provider Demographics
NPI:1932136645
Name:BOND, DAVID (LCSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BOND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 FAIRLANE DR C-7
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-1641
Mailing Address - Country:US
Mailing Address - Phone:334-551-0735
Mailing Address - Fax:334-551-0767
Practice Address - Street 1:5906 CARMICHAEL PLACE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-409-9090
Practice Address - Fax:334-409-9669
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL01511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL95792OtherBCBS
AL95792OtherBCBS
R60589Medicare UPIN