Provider Demographics
NPI:1932984028
Name:BOHL, ADRIENNE (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:BOHL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-3911
Mailing Address - Country:US
Mailing Address - Phone:701-320-4096
Mailing Address - Fax:
Practice Address - Street 1:2111 3RD ST SE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-3911
Practice Address - Country:US
Practice Address - Phone:701-320-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND57501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical