Provider Demographics
NPI:1881921179
Name:GOODSITE BONDY, ELIZABETH J (LPC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:J
Last Name:GOODSITE BONDY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N63W23524 SILVER SPRING DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3833
Mailing Address - Country:US
Mailing Address - Phone:262-204-2430
Mailing Address - Fax:
Practice Address - Street 1:N63W23524 SILVER SPRING DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-3833
Practice Address - Country:US
Practice Address - Phone:262-204-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0700352101YM0800X
WI5931-125101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health