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1952733594 NPI number — LORI JEAN BONEBRIGHT LADC

NPI Number: 1952733594
Health Care Provider/Practitioner: LORI JEAN BONEBRIGHT LADC

Information about “1952733594” NPI (LORI JEAN BONEBRIGHT LADC) exists in 1952733594 in HTML format HTML  |  1952733594 in plain Text format TXT  |  1952733594 in PDF (Portable Document Format) PDF  |  1952733594 in an XML format XML  formats.

NPI Number : 1952733594 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952733594",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BONEBRIGHT",
    "FirstName": "LORI",
    "MiddleName": "JEAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LADC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MCELROY",
    "OtherFirstName": "LORI",
    "OtherMiddleName": "JEAN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LADC-1125",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4215 SOUTH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LINCOLN",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68506-1155",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-730-8178",
    "MailingAddressFaxNumber": "402-742-9116",
    "FirstLinePracticeLocationAddress": "3200 O ST STE 5",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LINCOLN",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68510-1510",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-742-9616",
    "PracticeLocationAddressFaxNumber": "402-742-9116",
    "EnumerationDate": "08/06/2013",
    "LastUpdateDate": "04/13/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "1125",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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