Provider Demographics
NPI:1982789350
Name:HOHN, BEVERLY A (LICSW LCSW CDP CADCI)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:A
Last Name:HOHN
Suffix:
Gender:F
Credentials:LICSW LCSW CDP CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7507 NE 51ST ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6007
Mailing Address - Country:US
Mailing Address - Phone:360-906-1190
Mailing Address - Fax:360-906-1193
Practice Address - Street 1:7507 NE 51ST ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6007
Practice Address - Country:US
Practice Address - Phone:360-906-1190
Practice Address - Fax:360-906-1193
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00004447101YA0400X
ORL34961041C0700X
WALW000087241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164936Medicaid
OR0000WDBCHMedicare ID - Type UnspecifiedGROUP #