Healthcare Provider Details

I. General information

NPI: 1841706504
Provider Name (Legal Business Name): ALEXANDER LEE BOHNENKAMP MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 EASTON BLVD
DES MOINES IA
50317-3214
US

IV. Provider business mailing address

401 NE TRILEIN DR APT 201
ANKENY IA
50021-2037
US

V. Phone/Fax

Practice location:
  • Phone: 515-262-0349
  • Fax:
Mailing address:
  • Phone: 319-457-2317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number120850
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: