Bonovitz, Nathaniel

Bonovitz, Nathaniel is an individual health care provider with primary practice located at 1151 E Iron Eagle Dr , Eagle ID 83616-6854. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Bonovitz, Nathaniel can be contacted via phone (484) 557-5672.

Contact Information

Primary practice address
1151 E Iron Eagle Dr Eagle ID 83616-6854
Phone: (484) 557-5672
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 4869 Idaho
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC Idaho

Profile Details

NPI number 1154586550
LBN Legal business name Bonovitz, Nathaniel
Credentials LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2008
Last updated Jun 12th, 2023 - about last year

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 1154586550 NPPES
Idaho Other LPC #3820 LPC NUMBER

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