Richard Michael Bohannan, LCSW
Individual provider Active NPI Clinical Social Worker · Tempe, AZ
NPI 1013262963 · NPPES record last updated Jul 16, 2026
Key facts
- NPI
- 1013262963
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW-15674 (AZ)
- Practice address
- 2120 S McClintock Dr Ste 105
Tempe, AZ 85282-2692 - Phone
- (480) 804-0326
- NPI assigned
- Jul 17, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151124000142 | AZ | Practitioner - Clinical Social Worker | 5092015099 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-13380 | AZ | MD | Social Worker |
| LCSW-15674 | AZ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crisis Preparation and Recovery, Inc | Current |
Accepting new patients |
Locations
9321 W Thomas Rd
Ste 100
Phoenix, AZ 85037
10799 N 90th St
Ste 100
Scottsdale, AZ 85260
Phone (480) 804-0083
3260 N Hayden Rd
Ste 112
Scottsdale, AZ 85251
Phone (602) 264-9100
2120 S McClintock Dr
Ste 105
Tempe, AZ 85282
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-15674 | AZ | Yes |
| Social Worker | 104100000X | LMSW-13380 | AZ |
Addresses
Primary practice location
2120 S McClintock Dr Ste 105
Tempe, AZ 85282-2692
Mailing address
2120 S McClintock Dr Ste 105
Tempe, AZ 85282-2692
Phone (480) 804-0326
Other practice location 1
6232 N 7th St Ste 101
Phoenix, AZ 85014-1850
Phone (623) 850-4170
Other practice location 2
500 Az-89
Prescott, AZ 86301
Phone (480) 433-7509
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 073274 | Medicaid | AZ |
Other providers in Tempe, AZ
- Bodywise Chiropractic PLLC
- Bodywise Health PLLC
- Nicole Boeri
- Clay Charles Boettcher
- Courtney Alexandra Bogardus
- Emily N Bohn
- Linda Bohnet
- Katalin H Boleratzky
- Donald J Boles Jr.
- Jenny Lou Boles
All providers in Tempe, AZ · Clinical Social Worker in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.