Provider Demographics
NPI:1932246840
Name:BONACKER, WILLIAM SCOTT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:BONACKER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S 40TH ST
Mailing Address - Street 2:STE 312
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5243
Mailing Address - Country:US
Mailing Address - Phone:402-475-5069
Mailing Address - Fax:402-475-2350
Practice Address - Street 1:1919 S 40TH ST
Practice Address - Street 2:STE 312
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5243
Practice Address - Country:US
Practice Address - Phone:402-475-5069
Practice Address - Fax:402-475-2350
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE176101YM0800X
NE283101YP2500X
NE501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional