Provider Demographics
NPI:1124350863
Name:BONE, KEVIN ANTHONY (MS, LPC, LADC/MH)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:ANTHONY
Last Name:BONE
Suffix:
Gender:M
Credentials:MS, LPC, LADC/MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 10TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-5929
Mailing Address - Country:US
Mailing Address - Phone:580-226-1656
Mailing Address - Fax:844-270-7511
Practice Address - Street 1:9 10TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5929
Practice Address - Country:US
Practice Address - Phone:580-226-1656
Practice Address - Fax:844-270-7511
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional