Karyn Martin-Bohl, LCSW, RN, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-008705 Issued in IL

Practice address

129 S Phelps Ave
Suite 812
Rockford, IL 61108-2453

Phone

(815) 394-1555

Fax

(815) 394-1188

NPI assigned

Jan 27, 2007

Sex

Female

Sole proprietor

Yes

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1811043060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S PHELPS AVE",
            "address_2": "SUITE 812",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082453",
            "telephone_number": "815-394-1555",
            "fax_number": "815-394-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 S PHELPS AVE",
            "address_2": "SUITE 812",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082453",
            "telephone_number": "815-394-1555",
            "fax_number": "815-394-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-BOHL",
        "first_name": "KARYN",
        "credential": "LCSW, RN, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-008705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Marshall
• Susan A Marshall, AUD
• Marshmallows Hope Nonprofit Organization Corp.
• Max Marsili
• Martin Luther King Jr. Community Service Area Project
• Carlton Martin, LPC
• Carol A Martin, LCSW
• Jason Martin
• Jeffrey Martin, LCSW
• Kenneth Scott Martin, CADC

• Clinical Social Worker in Rockford, IL
• Providers in Rockford, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.