Provider Demographics
NPI:1134578305
Name:BONITA HUTCHINSON AND ASSOCIATES, PLLC
Entity type:Organization
Organization Name:BONITA HUTCHINSON AND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC,LCAS,CSI
Authorized Official - Phone:980-254-0046
Mailing Address - Street 1:5009 BEATTIES FORD RD
Mailing Address - Street 2:SUITE 107-233
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-2859
Mailing Address - Country:US
Mailing Address - Phone:980-254-0046
Mailing Address - Fax:980-231-2124
Practice Address - Street 1:1409 EAST BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5817
Practice Address - Country:US
Practice Address - Phone:980-254-0046
Practice Address - Fax:980-231-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2313101YA0400X
NC7953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty