Provider Demographics
NPI:1669268660
Name:BONSALL, ERIN JEAN (MSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:JEAN
Last Name:BONSALL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:JEAN
Other - Last Name:BEMIS-THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 BLYTHE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5865
Mailing Address - Country:US
Mailing Address - Phone:704-381-8840
Mailing Address - Fax:
Practice Address - Street 1:1001 BLYTHE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5865
Practice Address - Country:US
Practice Address - Phone:704-381-8840
Practice Address - Fax:704-381-8840
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker