Provider Demographics
NPI:1477555480
Name:BOHLIN, ERIK (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:BOHLIN
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 91ST AVE NE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258
Mailing Address - Country:US
Mailing Address - Phone:425-334-8916
Mailing Address - Fax:425-334-2427
Practice Address - Street 1:430 91ST AVE. NE
Practice Address - Street 2:SUITE 8
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258
Practice Address - Country:US
Practice Address - Phone:425-334-8916
Practice Address - Fax:425-334-2427
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional