Individual
MARIO SANTINO BUGNONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
2136 ASH ST, NORTH BEND, OR 97459-2118
(928) 380-1120
Mailing address
2136 ASH ST, NORTH BEND, OR 97459-2118
(928) 380-1120
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
I.2102756
OH
1041C0700X
Clinical Social Worker
Primary
I.2102756
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0383084
—
OH
Enumeration date
11/28/2016
Last updated
07/09/2025
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