Provider Demographics
NPI:1265746069
Name:GALVAN, BONNIE (LPC, LCDC, LSW, PCPE)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:GALVAN
Suffix:
Gender:F
Credentials:LPC, LCDC, LSW, PCPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 RANDOLPH DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3852
Mailing Address - Country:US
Mailing Address - Phone:915-422-2978
Mailing Address - Fax:888-745-9298
Practice Address - Street 1:1303 RANDOLPH DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3852
Practice Address - Country:US
Practice Address - Phone:915-422-2978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional