Provider Demographics
NPI:1629350079
Name:NANCY K BOHL, INC
Entity Type:Organization
Organization Name:NANCY K BOHL, INC
Other - Org Name:THE COUNSELING TEAM INTERNATIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-884-0133
Mailing Address - Street 1:PO BOX 10427
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92423-0427
Mailing Address - Country:US
Mailing Address - Phone:909-884-0133
Mailing Address - Fax:909-384-0734
Practice Address - Street 1:1881 BUSINESS CENTER DR STE 11
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3438
Practice Address - Country:US
Practice Address - Phone:909-884-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1184040222OtherJULIE RATHBUN
CA1265854665OtherANGELA RONAN
CA1164813374OtherAMANDA STEIGER
CA1407124761OtherKATHLEEN WELLBROCK
CA1962688796OtherWISCONSIN STURM
CA1548353873OtherDEBORAH SILVERIA
CA1578903175OtherANDREW CLACK
CA1922425776OtherCHRISTA WALLIS
CA1497172001OtherSARAH WILKINSON
CA1780872168OtherANGELIKA ROBINSON
CA1851701197OtherJAMES DONCKELS
CA1134488265OtherDEANA KAHLE
CA1629350079OtherNANCY BOHL-PENROD
CA1265854665OtherANGELA RONAN