MR. NATHANIEL BONOVITZ LCPC NPI 1154586550

NPI Information

NPI: 1154586550
Provider Name: MR. NATHANIEL BONOVITZ, LCPC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
1151 E IRON EAGLE DR
EAGLE, ID
ZIP 83616
Phone: (484) 557-5672
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MR. Nathaniel Bonovitz, LCPC is a mental health counselor in Eagle, ID with 18 years of experience. MR. Nathaniel Bonovitz, LCPC NPI is 1154586550. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1151 E IRON EAGLE DR
EAGLE, ID
ZIP 83616-854
Phone: (484) 557-5672

The NPI 1154586550 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/24/2008 and was last updated on 6/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	4869	IDAHO	No
2	101YM0800X	Counselor	Mental Health	LPC	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LPC #3820	OTHER	IDAHO	LPC NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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