Doctor Name: | CORRINE L BONCEK |
NPI Number: | 1134127053 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 34003423A |
Business Practice Address: | 54 N 9th St Suite 205 Noblesville, IN - 460602236 |
Business Phone Number: | 3175870567 |
Business Fax Number: | 3175741230 |
Mailing Address: | 697 Pro-med Ln, CARMEL |
State: | IN |
Postal Code: | 460325323 |
Phone Number: | 3175870567 |
Fax Number: | 3175741230 |
NPI Enumeration Date: | 07/13/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34003423A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |