Provider Demographics
NPI:1588261507
Name:PEGGY BONACCI COUNSELING LLC
Entity type:Organization
Organization Name:PEGGY BONACCI COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:BONACCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-800-7117
Mailing Address - Street 1:8031 W CENTER RD STE 324
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3149
Mailing Address - Country:US
Mailing Address - Phone:531-800-7117
Mailing Address - Fax:
Practice Address - Street 1:8031 W CENTER RD STE 324
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3149
Practice Address - Country:US
Practice Address - Phone:531-800-7117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty