Provider Demographics
NPI:1861948648
Name:KANE, BONNIE JEAN (LPC, LMT)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:JEAN
Last Name:KANE
Suffix:
Gender:F
Credentials:LPC, LMT
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:JEAN
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:2247 FINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5220
Mailing Address - Country:US
Mailing Address - Phone:267-872-9694
Mailing Address - Fax:267-748-1819
Practice Address - Street 1:3070 BRISTOL PIKE STE 2-218
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5361
Practice Address - Country:US
Practice Address - Phone:267-332-6605
Practice Address - Fax:215-748-1819
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015135101YM0800X, 101YP2500X
PAMSG009936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist