Provider Demographics
NPI:1750193629
Name:BONNIE LEE LANDAU WEED PROFESSIONAL CLINICAL COUNSELOR, INC.
Entity type:Organization
Organization Name:BONNIE LEE LANDAU WEED PROFESSIONAL CLINICAL COUNSELOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LANDAU WEED
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:805-669-6106
Mailing Address - Street 1:2674 E MAIN ST STE E523
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2820
Mailing Address - Country:US
Mailing Address - Phone:805-669-6106
Mailing Address - Fax:805-710-8882
Practice Address - Street 1:143 FIGUEROA ST STE 11
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2756
Practice Address - Country:US
Practice Address - Phone:805-669-6106
Practice Address - Fax:805-710-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty