Provider Demographics
NPI:1891283024
Name:JAHNS, BONNIE ELIZABETH (LMSW, LCSWA,RBT, CLC)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:ELIZABETH
Last Name:JAHNS
Suffix:
Gender:F
Credentials:LMSW, LCSWA,RBT, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 TUMBLING STONE WAY
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-5974
Mailing Address - Country:US
Mailing Address - Phone:860-501-1306
Mailing Address - Fax:
Practice Address - Street 1:1614 TUMBLING STONE WAY
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-5974
Practice Address - Country:US
Practice Address - Phone:860-501-8834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTRBT-23-263247106S00000X
CT9769104100000X
NCP022777104100000X
174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No174N00000XOther Service ProvidersLactation Consultant, Non-RN