NICOLE RAASTAD BONHAM MA
NPI 1336572981
Counselor - Professional in Johnson City, TN

Q: What is Nicole Bonham's NPI number?

The NPI number for Nicole Bonham is 1336572981. It was assigned to this individual provider in the NPPES registry on August 19, 2013. The provider is also known as Nicole L Raastad Ma.

Q: What is Nicole Bonham's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Bonham was last updated on October 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 19, 2013PECOS Enrolled

109 W WATAUGA AVE, JOHNSON CITY, TN 37604(423) 232-2600(423) 467-3644 Get Directions Write a Review

NPPES record last updated: October 23, 2015. Verified against the NPPES registry weekly; last sync: August 23, 2026.

On this page

About Nicole Raastad Bonham Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE RAASTAD BONHAM MA (NPI 1336572981) is an individual professional provider in Johnson City, Tennessee, licensed in Tennessee (3525) and active in the NPI registry since August 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336572981

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameNICOLE RAASTAD BONHAMCredential: MA

Location Address109 W WATAUGA AVEJohnson City, TN 37604-5621

Mailing Address1167 Spratlin Park Dr, Po Box 9054Gray, TN 37615-6205 · (423) 467-3600 · Fax (423) 467-3644

Phone(423) 232-2600

Fax(423) 467-3644

Sole ProprietorNo

Enumeration DateAugust 19, 2013

Last NPPES UpdateOctober 23, 2015

✔ NPI 1336572981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in TN · 3525

Also ListedCounselorTaxonomy 101Y00000X

109 W WATAUGA AVE, Johnson City, TN 37604

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Other Names 1

Former Name (1)Nicole L Raastad Ma

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Raastad Bonham Ma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACQUELINE KATKO BS

Case Manager/Care Coordinator

109 W WATAUGA AVE
JOHNSON CITY, TN 37604

Washington County (423) 232-2600

MATTHEW M MIDKIFF LPC, MHSP

Counselor (Professional)

109 W WATAUGA AVE
JOHNSON CITY, TN 37604

Washington County (423) 232-2600

KIM MARIE DICKSON BACHELORS

Case Manager/Care Coordinator

109 W WATAUGA AVE, WATAUGA BEHAVIORAL HEALTH
JOHNSON CITY, TN 37604

Washington County (423) 232-2788

MR. JONATHAN JUNIOR PERKINS MED

Counselor

109 W WATAUGA AVE
JOHNSON CITY, TN 37604

Washington County (423) 232-2600

HANNAH T SHANNON LPC/ MHSP

Counselor (Professional)

109 W WATAUGA AVE
JOHNSON CITY, TN 37604

Washington County (423) 232-2600

HALEY N CIGARROA LPC/ MHSP

Counselor (Professional)

109 W WATAUGA AVE
JOHNSON CITY, TN 37604

Washington County (423) 232-2600

ISAAC LEE MARTIN JR. MRC CRC

Personal Emergency Response Attendant

109 W WATAUGA AVE
JOHNSON CITY, TN 37604

Washington County (423) 232-2600

ADAM WAYNE DAVIS

Case Manager/Care Coordinator

109 W WATAUGA AVE
JOHNSON CITY, TN 37604

Washington County (423) 232-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Bonham's NPI number?

The NPI number for Nicole Bonham is 1336572981. It was assigned to this individual provider in the NPPES registry on August 19, 2013. The provider is also known as Nicole L Raastad Ma.

Where is Nicole Bonham located?

Nicole Bonham practices at 109 W Watauga Ave, Johnson City, TN 37604. The listed phone number is (423) 232-2600.

What is Nicole Bonham's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Nicole Bonham enrolled in Medicare?

Yes. Nicole Bonham is registered in the Medicare PECOS enrollment system.

What insurance does Nicole Bonham accept?

Health plans from BlueCross BlueShield of Tennessee list Nicole Bonham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicole Bonham was last updated on October 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.