Bonnie Neidecker Soukup, LMHC, NCC

NPI #1558837880 in Islip, New York

Provider Information

NPI Number: 1558837880
Entity Type: Individual
Name: Bonnie Neidecker Soukup, LMHC, NCC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: LMHC, NCC
Enumeration Date: Oct 14, 2018
Last Updated: Oct 14, 2018

Practice Location

Address: 435 MAIN ST STE 5
City: Islip
State: New York
ZIP Code: 11751-3536
Phone: (631) 664-1582

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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