Provider Demographics
NPI:1861964603
Name:BIRKMEYER, BONNIE SUE (LMHC)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:SUE
Last Name:BIRKMEYER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-4230
Mailing Address - Country:US
Mailing Address - Phone:716-548-9904
Mailing Address - Fax:716-439-5430
Practice Address - Street 1:66 STEVENS ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-4230
Practice Address - Country:US
Practice Address - Phone:716-548-9904
Practice Address - Fax:716-439-5430
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000712-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health