Provider Demographics
NPI:1649939166
Name:LOCHAN, BONITA (LMHC)
Entity type:Individual
Prefix:
First Name:BONITA
Middle Name:
Last Name:LOCHAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 RUTLAND RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-1751
Mailing Address - Country:US
Mailing Address - Phone:917-741-6680
Mailing Address - Fax:
Practice Address - Street 1:288 RUTLAND RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-1751
Practice Address - Country:US
Practice Address - Phone:917-741-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00825900101YM0800X
NY006518-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health