Provider Demographics
NPI:1134459027
Name:BOHRER, TEAL (PHD, LPC, CADC III)
Entity Type:Individual
Prefix:DR
First Name:TEAL
Middle Name:
Last Name:BOHRER
Suffix:
Gender:F
Credentials:PHD, LPC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1381 BONNIEBRAE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-1627
Mailing Address - Country:US
Mailing Address - Phone:503-750-8325
Mailing Address - Fax:
Practice Address - Street 1:1381 BONNIEBRAE DR
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-1627
Practice Address - Country:US
Practice Address - Phone:503-750-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
ORC3707103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health