Provider Demographics
NPI:1942665096
Name:LEWIS, BONNIE L (LAMFT)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:L
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 E VIA DE COMMERCIO
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3595
Mailing Address - Country:US
Mailing Address - Phone:928-362-0942
Mailing Address - Fax:
Practice Address - Street 1:8737 E VIA DE COMMERCIO STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3595
Practice Address - Country:US
Practice Address - Phone:480-888-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-10483106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist