Provider Demographics
NPI:1467687418
Name:BOHMAN, ELIZABETH SUZANNE (MA, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:SUZANNE
Last Name:BOHMAN
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 842
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-0842
Mailing Address - Country:US
Mailing Address - Phone:304-704-6326
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 67
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-9503
Practice Address - Country:US
Practice Address - Phone:304-704-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1692101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional