Healthcare Provider Details

I. General information

NPI: 1477613453
Provider Name (Legal Business Name): PROFESSIONAL PSYCHOLOGY & CONSULTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 WILMINGTON AVE
DAYTON OH
45420
US

IV. Provider business mailing address

1136 WILMINGTON AVE
DAYTON OH
45420
US

V. Phone/Fax

Practice location:
  • Phone: 937-254-6700
  • Fax: 937-254-6776
Mailing address:
  • Phone: 937-254-6700
  • Fax: 937-254-6776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHLEEN A BONIE
Title or Position: OWNER DIRECTOR
Credential: PHD
Phone: 937-254-6700