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General NPI Number Information
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NPI Number | 1912138033
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Entity Type | Individual
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Provider Name | COURTNEY ANNE BOKELMAN LISW-S
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 10495 MONTGOMERY RD STE 20
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City | MONTGOMERY
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State | OH
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Zip | 45242-4420
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Country | US
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Telephone | 513-862-2920
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Fax | 513-487-5685
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Provider Business Mailing Address
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Address Line | 10495 MONTGOMERY RD STE 20
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City | MONTGOMERY
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State | OH
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Zip | 45242-4420
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Country | US
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Telephone | 513-862-2920
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Fax | 513-487-5685
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1000074
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License Number State | OH
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