Provider Demographics
NPI:1962893305
Name:BONIN, ALAN WILFRED (LMHC, LADC, LPC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:WILFRED
Last Name:BONIN
Suffix:
Gender:M
Credentials:LMHC, LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 STARKWEATHER RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06374-1749
Mailing Address - Country:US
Mailing Address - Phone:401-206-1531
Mailing Address - Fax:
Practice Address - Street 1:567 VAUXHALL STREET EXT STE 201
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4332
Practice Address - Country:US
Practice Address - Phone:401-206-1531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-06
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1156101YA0400X
RIMHC00954101YM0800X
CT5178101YP2500X
MA14120101YA0400X
RICDP00609101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional