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Individual
KIMBERLY A BONVINO
Active
Individual
KIMBERLY A BONVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D. LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PC003417
PA
101YM0800X
Mental Health Counselor
PC003417
PA
101YP2500X
Professional Counselor
Primary
PC003417
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
835262000
MAGELLAN BEHAVIORAL HEALT
PA
Enumeration date
07/29/2006
Last updated
12/08/2025
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