Bonaventura, Deanna

Bonaventura, Deanna is an individual health care provider with primary practice located at 352 State St , North Haven CT 06473-3108. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Bonaventura, Deanna can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
352 State St North Haven CT 06473-3108
Fax: (203) 498-3820
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 3305 Connecticut

Profile Details

NPI number 1922515196
LBN Legal business name Bonaventura, Deanna
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2018
Last updated Feb 14th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922515196 NPPES
Connecticut MEDICAID 008056168
Connecticut MEDICAID 008077565
Connecticut MEDICAID 004082286
Connecticut MEDICAID 008022626
Connecticut MEDICAID 500000315

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