Provider Demographics
NPI:1669532321
Name:BOMHOFF, BEVERLY ANN (MSW/LCSW)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ANN
Last Name:BOMHOFF
Suffix:
Gender:
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 38TH STREET
Mailing Address - Street 2:SUITE #100E
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2623
Mailing Address - Country:US
Mailing Address - Phone:303-650-3158
Mailing Address - Fax:303-938-8288
Practice Address - Street 1:1650 38TH STREET
Practice Address - Street 2:SUITE #100E
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2623
Practice Address - Country:US
Practice Address - Phone:303-650-3158
Practice Address - Fax:303-938-8288
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9860881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical