Provider Demographics
NPI:1164679932
Name:BOHENEK, OREANA D (LCSW)
Entity Type:Individual
Prefix:
First Name:OREANA
Middle Name:D
Last Name:BOHENEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:OREANA
Other - Middle Name:B
Other - Last Name:HARLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8284 W MORNIN MIST CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-0777
Mailing Address - Country:US
Mailing Address - Phone:208-850-2726
Mailing Address - Fax:208-375-2023
Practice Address - Street 1:444 W FORT ST FL 2
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4535
Practice Address - Country:US
Practice Address - Phone:208-422-1018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW11651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDL6114OtherBLUE CROSS