Provider Demographics
NPI:1306148945
Name:BONAR, TED C (PSYD)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:C
Last Name:BONAR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 OAK ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2145
Mailing Address - Country:US
Mailing Address - Phone:773-426-5147
Mailing Address - Fax:
Practice Address - Street 1:1533 OAK ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2145
Practice Address - Country:US
Practice Address - Phone:773-426-5147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008839103T00000X
OH6971103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist