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JESSICA KATHLEEN BONATAKIS PSY.D.
NPI 1679706113
Psychologist - Clinical Child & Adolescent in Hershey, PA

Active since September 01, 2009PECOS EnrolledAccepts Medicare Assignment
22 NORTHEAST DR, HERSHEY, PA 17033(717) 531-8338(717) 531-6250 Get Directions Write a Review

NPPES record last updated: June 21, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 21, 2021, Aug 1, 2019, Jun 15, 2016 (3 updates tracked since 2016).

About Jessica Kathleen Bonatakis Psy.d. NPPES

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

JESSICA KATHLEEN BONATAKIS PSY.D. (NPI 1679706113) is an individual clinical child & adolescent provider in Hershey, Pennsylvania, licensed in Pennsylvania (PS018803) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1679706113
Entity TypeIndividualFemale
Primary Taxonomy103TC2200X
Provider Legal NameJESSICA KATHLEEN BONATAKISCredential: PSY.D.
Location Address22 NORTHEAST DRHershey, PA 17033-2732
Mailing AddressPo Box 858, Mc A410Hershey, PA 17033-0858 · (800) 243-1455
Phone(717) 531-8338
Fax(717) 531-6250
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateSeptember 1, 2009
Last NPPES UpdateJune 21, 20213 updates tracked since enumeration
NPPES CertifiedJune 21, 2021
✔ NPI 1679706113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers
Taxonomy Code103TC2200X
License✔ Licensed in PA · PS018803
Definition
A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 129694 (KY)
22 NORTHEAST DR, Hershey, PA 17033
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Other Names 1

Former Name (1)Jessica Kathleen Bonatakis Psyd

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jessica Kathleen Bonatakis Psy.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4981877610
PECOS Enrollment IDI20190731000016
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.

SUSAN LYNN CALHOUN PHD
Psychologist (Clinical)
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (717) 531-8338
TIMOTHY SOISSON LSW
Social Worker
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (717) 531-8338
LINDA REAGGS RN
Registered Nurse (Psychiatric/Mental Health)
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (717) 531-8338
JACLYN SUZANNE NORTHRIDGE LCSW
Social Worker (Clinical)
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (717) 531-8338
SCOTT S BUNCE PHD.
Psychologist
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (717) 531-8338
VERONICA MIA JUSINO LPC, CAADC
Counselor (Professional)
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (717) 531-8338
MARCI J HOUCK LCSW
Social Worker (Clinical)
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (800) 243-1455
ANDREA LAYTON
Behavior Analyst
22 NORTHEAST DR
HERSHEY, PA 17033
Dauphin County (717) 531-8338

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 Jessica Bonatakis's NPI number?

The NPI number for Jessica Bonatakis is 1679706113. It was assigned to this individual provider in the NPPES registry on September 1, 2009. The provider is also known as Jessica Kathleen Bonatakis Psyd.

Where is Jessica Bonatakis located?

Jessica Bonatakis practices at 22 Northeast Dr, Hershey, PA 17033. The listed phone number is (717) 531-8338.

What is Jessica Bonatakis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Jessica Bonatakis enrolled in Medicare?

Yes. Jessica Bonatakis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jessica Bonatakis was last updated on June 21, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.