Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeffrey A Bonack, BA, MDIV

Individual provider Professional Counselor · NPI 1033724299

Jeffrey A Bonack, BA, MDIV is a Mental Health Counselor in Milwaukee, Wisconsin. Qualified in 2021, 5 years ago. Practices with Wisconsin Lutheran Child and Family Service Inc, a 35-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2020
What do these letters mean?
BA — Bachelor of Arts
An undergraduate arts degree.

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Practice location Address checks out

2669 N Richards St
Milwaukee, WI 53212-2850
Phone: (800) 438-1772
Fax: (262) 345-5562
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 16535 W Bluemound Rd Ste 305, Brookfield, WI 53005-5936 — (800) 438-1772

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 5121-226 (WI)

Record details

NPI number1033724299
Entity typeIndividual (Type 1)
GenderMale
Credentials BA , MDIV
Sole proprietorNo
NPI enumeratedSeptember 14, 2020
Last updated in NPPESNovember 9, 2021
Certification dateNovember 9, 2021
Mailing addressW175n11120 Stonewood Dr, Germantown, WI 53022-4799

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Wisconsin Lutheran Child And Family Service Inc — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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