Provider Demographics
NPI:1861726358
Name:ZAWILLA, BONNIE (LCSW, MSW, CCADC)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:ZAWILLA
Suffix:
Gender:F
Credentials:LCSW, MSW, CCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:PRESTO
Mailing Address - State:PA
Mailing Address - Zip Code:15142-1122
Mailing Address - Country:US
Mailing Address - Phone:412-403-2595
Mailing Address - Fax:412-249-8767
Practice Address - Street 1:307 4TH AVE
Practice Address - Street 2:SUITE 1100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2108
Practice Address - Country:US
Practice Address - Phone:412-403-2595
Practice Address - Fax:412-249-8767
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5339101YA0400X
PACWO143161041C0700X
PACW014316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA802772Medicare PIN