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General NPI Number Information
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NPI Number | 1033123328
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Entity Type | Individual
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Provider Name | KIMBERLY A BONVINO PH.D. LPC
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Gender | Female
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 587 BETHLEHEM PIKE STE 400
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City | MONTGOMERYVILLE
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State | PA
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Zip | 18936-1301
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Country | US
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Telephone | 267-994-1847
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Fax |
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Provider Business Mailing Address
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Address Line | 21 HOLLAND DR
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City | CHALFONT
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State | PA
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Zip | 18914-2701
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Country | US
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Telephone | 267-994-1847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC003417
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC003417
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC003417
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License Number State | PA
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