MEDICARE: MONICA LYNN BONIN M.S., LAC, AADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LAC-5167	LA

General Provider Information

NPI Number	:	1609474519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA LYNN BONIN M.S., LAC, AADC

Provider Business Mailing Address
First Line	:	718 16TH ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-7439
Country	:	US
Telephone Number	:	337-513-6121
Fax Number	:

Provider Business Practice Location Address
First Line	:	2507 HODGES ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-7309
Country	:	US
Telephone Number	:	337-513-6121
Fax Number	:

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

Provider Enumeration Date	:	10/13/2020
Last Update Date	:	11/05/2025

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