Ann Marie Bohlman, LCSW

Individual provider Active NPI Clinical Social Worker · Monona, WI

NPI 1104991975 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104991975
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
7018-123 (WI)
Practice address
4915 Monona Dr
Suite 305
Monona, WI 53716-2665
Phone
(608) 223-1506
Fax
(608) 223-1745
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7018-123 WI Yes

Addresses

Primary practice location

4915 Monona Dr
Suite 305
Monona, WI 53716-2665

Mailing address

4915 Monona Dr.
Suite 305
Madison, WI 53716
Phone (608) 223-1506

Other identifiers

IdentifierTypeStateIssuer
04154B102MedicaidWI

Other providers in Monona, WI

All providers in Monona, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.