Provider Demographics
NPI:1356568380
Name:BONNHEIM, BEVERLY GEIGER (MSSW)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:GEIGER
Last Name:BONNHEIM
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 SPRING VALLEY RD
Mailing Address - Street 2:SUITE 511
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-3629
Mailing Address - Country:US
Mailing Address - Phone:972-934-1485
Mailing Address - Fax:972-934-1498
Practice Address - Street 1:4100 SPRING VALLEY RD
Practice Address - Street 2:SUITE 511
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-3629
Practice Address - Country:US
Practice Address - Phone:972-934-1485
Practice Address - Fax:972-934-1498
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX052921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical