MEDICARE: ALEXA KRISLYN BONK MS

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
1	101YM0800X	Mental Health Counselor		PA

General Provider Information

NPI Number	:	1114850013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA KRISLYN BONK MS

Provider Business Mailing Address
First Line	:	801 MOLTKE AVE
Second Line	:
City	:	SCRANTON
State	:	PA
Zip	:	18505-2621
Country	:	US
Telephone Number	:	570-468-7616
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 ABINGTON EXECUTIVE PARK STE 9
Second Line	:
City	:	CLARKS SUMMIT
State	:	PA
Zip	:	18411-2269
Country	:	US
Telephone Number	:	570-290-7733
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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