Provider Demographics
NPI:1811322316
Name:SCRANTON, BONNIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:SCRANTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:SCRANTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:45 WINTONBURY AVE
Mailing Address - Street 2:SUITE 318
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2470
Mailing Address - Country:US
Mailing Address - Phone:860-878-8142
Mailing Address - Fax:860-242-1476
Practice Address - Street 1:45 WINTONBURY AVE
Practice Address - Street 2:SUITE 318
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2470
Practice Address - Country:US
Practice Address - Phone:860-878-8142
Practice Address - Fax:860-242-1476
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT74031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical