Provider Demographics
NPI:1598291783
Name:BOHNET, LINDA (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BOHNET
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 S LAKESHORE DR STE 411
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7127
Mailing Address - Country:US
Mailing Address - Phone:602-551-6747
Mailing Address - Fax:602-680-2541
Practice Address - Street 1:4625 S LAKESHORE DR STE 411
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7127
Practice Address - Country:US
Practice Address - Phone:602-551-6747
Practice Address - Fax:602-680-2541
Is Sole Proprietor?:No
Enumeration Date:2017-05-07
Last Update Date:2023-06-30
Deactivation Date:2018-08-18
Deactivation Code:
Reactivation Date:2020-03-11
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16634101YP2500X, 101YM0800X, 102L00000X, 225C00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor