Doctor Name: | MRS. CAROL ANN BONGIORNO |
NPI Number: | 1326361858 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 6794 |
Business Practice Address: | 23 Railroad Ave Suites 5 And 7 Swampscott, MA - 019071858 |
Business Phone Number: | 7817803037 |
Business Fax Number: | 9787500370 |
Mailing Address: | 23 Railroad Ave, Suite 5 And 7 SWAMPSCOTT |
State: | MA |
Postal Code: | 019071858 |
Phone Number: | 7817803037 |
Fax Number: | 9787500370 |
NPI Enumeration Date: | 03/11/2010 |
NPI Last Update Date: | 03/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6794 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |