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Nicole Raastad Bonham, MA
Counselor in Johnson City, Tennessee
NPI 1336572981

Nicole Raastad Bonham is a Counselor based in Gray, TN. Nicole Raastad Bonham practices in Johnson City, TN and has the professional credentials of MA. The NPI Number for Nicole Raastad Bonham is 1336572981 and holds a License No. 3525 (Tennessee).

The current practice location address for Nicole Raastad Bonham is 109 W Watauga Ave, Johnson City, TN and can be reached out via phone at 423-232-2600 and via fax at 423-467-3644.

Location: 109 W Watauga Ave, Johnson City, TN, 37615-6205
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336572981
Provider Name
Nicole Raastad Bonham
Credential
MA
Provider Entity Type
Individual
Gender
Female
Address
109 W Watauga Ave, Johnson City, TN, 37615-6205
Phone Number
423-232-2600
Fax Number
423-467-3644
Provider Enumeration Date
08/19/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
109 W Watauga Ave
City
Johnson City
State
Tennessee
Zip
37604-5621
Phone Number
423-232-2600
Fax Number
423-467-3644
person
Provider Business Mailing Address Details
Address
109 W Watauga Ave
City
Johnson City
State
Tennessee
Zip
37604-5621
Phone Number
423-232-2600
Fax Number
423-467-3644
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
3525 (Tennessee)
Definition
Definition to come...
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