DR. DAVID RALPH BONIELLO (NPI# 1104888965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104888965 |
| Entity Type | Individual |
| Full Name | DR. DAVID RALPH BONIELLO |
| Credential | PHD HSPP |
| Practice Address |
802 Columbia St Lafayette IN 47901-1439 |
| Mailing Address |
912 Brookridge Ct Lafayette IN 47909-6231 |
| Practice Telephone | 7657420802 |
| Practice Fax Number | 7657420806 |
| Mailing Telephone | 7654712774 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2008-06-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | HSPP20040640A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | MAGELLAN BEH HEALTH | 061941000 | 01 |
| IN | BLUE CROSS AND BLUE SHIELD | 000000513557 | 01 |
| IN | AETNA | 0007962135 | 01 |
| Street Address |
802 COLUMBIA ST |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47901-1439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184068058 | Abigail Christiansen | Marriage & Family Therapist | 802 Columbia St, Lafayette, IN 47901-1439 | 2013-04-23 |
| 1841520301 | William Charles Madden | Counselor | 802 Columbia St, Lafayette, IN 47901-1439 | 2010-01-06 |
| 1942368626 | David James Kiser | Social Worker | 802 Columbia St, Lafayette, IN 47901-1439 | 2006-12-05 |
| 1144327115 | Julia M Mills | Social Worker | 802 Columbia St, Lafayette, IN 47901-1439 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689138398 | Amie Leigh Gallegos | Physical Therapy Assistant | 2741 N Salisbury St, West Lafayette, IN 47901 | 2019-01-27 |
| 1780876656 | William Everett Clymer IIi | Social Worker | 420 Columbia Street, Suite 205, Lafayette, IN 47901 | 2007-08-15 |
| 1780885731 | Purdue University | Clinic/Center | 509 North Street, Lafayette, IN 47901 | 2007-05-29 |
| 1184846727 | Donnamarie Marie Flanagan | Social Worker | 420 Columbia St, Suite 205, Lafayette, IN 47901 | 2007-05-03 |
| 1326269200 | Cleveland G. Shields | Marriage & Family Therapist | 802 Columbia Street, Lafayette, IN 47901 | 2007-05-01 |
| 1861539884 | New Community School | Local Education Agency (LEA) | 710 North St., Lafayette, IN 47901 | 2007-01-31 |
| 1962445387 | Doug A Essex | Counselor | 610 Main Street, Lafayette, IN 47901 | 2006-06-14 |
| 1629250618 | Westcentral Indiana Neonatal Group | Pediatrics | 501 N 3rd St, Lafayette, IN 47901-1001 | 2007-11-30 |
| 1265655831 | William B. Risk | Dentist | 609 N 5th St, Lafayette, IN 47901-1012 | 2007-04-11 |
| 1912992439 | Jeffrey Jon Yocum | Optometrist | 637 Ferry St, Lafayette, IN 47901-1143 | 2005-09-12 |
| Find all providers in zip 47901 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083116651 | Laura Kathleen Williams | Psychologist | 935 Moraga Rd Ste 215, Lafayette, CA 94549-4562 | 2018-02-28 |
| 1649780958 | Elizabeth Owens | Psychologist | 3468 Mt Diablo Blvd Ste B200, Lafayette, CA 94549-7102 | 2017-10-02 |
| 1598126351 | Acadiana Medical Psychological Services, LLC | Psychologist | 93 Magnate Dr, Lafayette, LA 70508-3840 | 2016-03-08 |
| 1023476892 | Mary L. Freeman, Ph.d. | Psychologist | 601 W Saint Mary Blvd Ste 406, Lafayette, LA 70506-3564 | 2016-02-08 |
| 1457729329 | Elyse Marie Manteris | Psychologist | 582 Beauprez Ave, Lafayette, CO 80026-3455 | 2015-09-09 |
| 1982015764 | Taylor Kathleen Locker | Psychologist | 678b N 36th St, Lafayette, IN 47905-4474 | 2014-05-14 |
| 1013341072 | Christopher David Keiper | Psychologist | 616 S 15th St, Lafayette, IN 47905-1232 | 2013-08-27 |
| 1730468216 | Janine Danniballe | Psychologist | 1245 Ilium Cir, Lafayette, CO 80026-1217 | 2011-08-15 |
| 1750674024 | Louisiana Geriatric Psychological Services, A Professional Corporation | Psychologist | 2851 Johnston St, Suite 313, Lafayette, LA 70503-3243 | 2011-05-19 |
| 1356555874 | Renee Babin Bonin | Psychologist | 200 Beaullieu Dr Bldg 9b-1, Lafayette, LA 70508-7230 | 2007-05-10 |
| Find all providers in LAFAYETTE | ||||
Please comment or provide details below to improve the information on DR. DAVID RALPH BONIELLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.