Miranda Sue Bohlken, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06264 Issued in IA

Practice address

655 Liberty Way
Suite 6
North Liberty, IA 52317-9154

Phone

(319) 665-2137

Fax

(319) 665-2137

NPI assigned

Jun 27, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1750588364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 HEMLOCK PL NE",
            "address_2": "APT. 1",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524028816",
            "telephone_number": "563-581-2673",
            "fax_number": "866-387-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 LIBERTY WAY",
            "address_2": "SUITE 6",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179154",
            "telephone_number": "319-665-2137",
            "fax_number": "319-665-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLKEN",
        "first_name": "MIRANDA",
        "middle_name": "SUE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Bockelman
• Kiley Carr Boeding
• Anna Boes
• Alicia Bogard, LMT
• Anna Boge, L.M.T., M.M.P.
• Justin Bonzato, DPT
• Emily Borgus, AGPCNP
• Brian C. Bowshier, M.D.
• Jason Troy Bradley, DC, ND, IFMCP
• Brittany Brdicko, LISW, LCSW

• Clinical Social Worker in North Liberty, IA
• Providers in North Liberty, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.