Individual
DR. CHARLES W. BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5873 FORBES AVE, PITTSBURGH, PA 15217-1601
(412) 422-9106
(412) 422-8180
Mailing address
5665 MELVIN ST, PITTSBURGH, PA 15217-2210
(412) 422-9160
(412) 422-8180
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-00719-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015318310004
—
PA
01
—
111914000
MAGELLAN BEHAVIORALHEALTH
PA
01
—
781511
HIGHMARK BC/BS
PA
Enumeration date
09/21/2005
Last updated
03/15/2024
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