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NPI Code Detail

MEDICARE: JACILYN BONDY LPC, LCDC

MEDICARE: JACILYN BONDY LPC, LCDC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor74374TX

General Provider Information

NPI Number : 1326491051
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACILYN BONDY LPC, LCDC
Provider Business Mailing Address
First Line : 14802 JONES MALTSBERGER RD STE 1101
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-3571
Country : US
Telephone Number : 210-490-4419
Fax Number :
Provider Business Practice Location Address
First Line : 14802 JONES MALTSBERGER RD STE 1101
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-3571
Country : US
Telephone Number : 432-661-3996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2016
Last Update Date : 05/11/2021

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Directions to “ JACILYN BONDY LPC, LCDC” Practice Location

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