Evans, Bonnie Jean
Evans, Bonnie Jean is an individual health care provider with primary practice located at 111 Big Sky Ave Sw , Los Lunas NM 87031-6155. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Evans, Bonnie Jean can be contacted via phone (505) 865-9026.Contact Information
Primary practice address
111 Big Sky Ave Sw
Los Lunas NM 87031-6155
Phone: (505) 865-9026
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 0097631 | New Mexico |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | CCMH0104231 | New Mexico |
Profile Details
| NPI number | 1366863706 |
|---|---|
| LBN Legal business name | Evans, Bonnie Jean |
| Credentials | LPCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 3rd, 2014 |
| Last updated | Jan 12th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366863706 | NPPES |
| New Mexico | Other | 0097631 | LICENSE |
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