Active NPI
Gordon George Bohl, LCSW
- Clinical Social Worker
- Port St Lucie, FL
National Provider Identifier
1215024229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW3235
- Practice address
- 8241 S US 1
Port St Lucie, FL 34952 - Phone
- (772) 878-9368
- Fax
- (772) 878-9378
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW3235 | FL | Primary |
Addresses
Primary practice location
8241 S US 1
Port St Lucie, FL 34952
Mailing address
8241 S US 1
Port St Lucie, FL 34952
Phone (772) 878-9368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW3235 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215024229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8241 S US 1",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "34952",
"telephone_number": "772-878-9368",
"fax_number": "772-878-9378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8241 S US 1",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "34952",
"telephone_number": "772-878-9368",
"fax_number": "772-878-9378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOHL",
"first_name": "GORDON",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW3235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.