Provider Demographics
NPI:1538581103
Name:WHEELER, BONITA (LMSW)
Entity type:Individual
Prefix:
First Name:BONITA
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5158
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-5158
Mailing Address - Country:US
Mailing Address - Phone:864-582-2411
Mailing Address - Fax:864-582-7178
Practice Address - Street 1:460 LANGDON ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1614
Practice Address - Country:US
Practice Address - Phone:864-582-2411
Practice Address - Fax:864-594-0040
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC106351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical