1922309988 NPI number — MRS. LAUREN ELIZABETH BONO SUNSHINE LCSW

Table of content: MRS. LAUREN ELIZABETH BONO SUNSHINE LCSW (NPI 1922309988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922309988 NPI number — MRS. LAUREN ELIZABETH BONO SUNSHINE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BONO SUNSHINE
Provider First Name:
LAUREN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BONO
Provider Other First Name:
LAUREN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922309988
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
964 FELICITY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70130-4669
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-801-8284
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2121 RIDGELAKE DR
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70001-2080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-232-3334
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  10720 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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