Healthcare Provider Details

I. General information

NPI: 1457974867
Provider Name (Legal Business Name): BONIERY BELL MA, LCMHC, LCAS, CCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 EAST BLVD STE. E # 1209
CHARLOTTE NC
28203-5870
US

IV. Provider business mailing address

1235 EAST BLVD STE. E # 1209
CHARLOTTE NC
28203-5870
US

V. Phone/Fax

Practice location:
  • Phone: 980-999-0170
  • Fax:
Mailing address:
  • Phone: 980-999-0170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: