Healthcare Provider Details

I. General information

NPI: 1477555480
Provider Name (Legal Business Name): ERIK BOHLIN M.A., LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9623 32ND ST SE STE 110
LAKE STEVENS WA
98258-5779
US

IV. Provider business mailing address

9623 32ND ST SE STE A110
LAKE STEVENS WA
98258-5797
US

V. Phone/Fax

Practice location:
  • Phone: 425-334-8916
  • Fax: 425-368-3738
Mailing address:
  • Phone: 425-334-8916
  • Fax: 425-368-3738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH00004543
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: