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NPI Code Detail

MEDICARE: MS. VINCENZA C BONARELLI LCSW

MEDICARE: MS. VINCENZA C BONARELLI LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904005543VA

General Provider Information

NPI Number : 1043267370
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VINCENZA C BONARELLI LCSW
Provider Business Mailing Address
First Line : PO BOX 593
Second Line :
City : KESWICK
State : VA
Zip : 22947-0593
Country : US
Telephone Number : 434-295-8514
Fax Number : 434-295-3299
Provider Business Practice Location Address
First Line : 1224 JEFFERSON PARK AVE
Second Line : SUITE 608
City : CHARLOTTESVILLE
State : VA
Zip : 22903-3410
Country : US
Telephone Number : 434-295-8514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2006
Last Update Date : 07/08/2007

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