Provider Demographics
NPI:1801665708
Name:DONALDSON, BONNIE (LCDC, CFLE)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:LCDC, CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1146
Mailing Address - Street 2:
Mailing Address - City:VAN ALSTYNE
Mailing Address - State:TX
Mailing Address - Zip Code:75495-1146
Mailing Address - Country:US
Mailing Address - Phone:214-585-1414
Mailing Address - Fax:
Practice Address - Street 1:156 DANIEL DR
Practice Address - Street 2:
Practice Address - City:VAN ALSTYNE
Practice Address - State:TX
Practice Address - Zip Code:75495-2926
Practice Address - Country:US
Practice Address - Phone:214-585-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2024-12-11
Deactivation Date:2024-01-26
Deactivation Code:
Reactivation Date:2024-12-11
Provider Licenses
StateLicense IDTaxonomies
TX16639101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty