Healthcare Provider Details

I. General information

NPI: 1306365978
Provider Name (Legal Business Name): REBECCA SUE BONFEY LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LAURA JACKSON RD
FAIRVIEW NC
28730-8700
US

IV. Provider business mailing address

18 HOMEWOOD DR
ASHEVILLE NC
28803-1247
US

V. Phone/Fax

Practice location:
  • Phone: 518-866-7323
  • Fax: 828-505-4874
Mailing address:
  • Phone: 828-225-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA13013
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: