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NPI Code Detail

MEDICARE: CANDACE S BOHANAN LPC

MEDICARE: CANDACE S BOHANAN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideOH
2101YM0800XMental Health CounselorC.1600612OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255706651
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE S BOHANAN LPC
Provider Business Mailing Address
First Line : 5000 CARBONDALE DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-4559
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1289 E LIVINGSTON AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-2838
Country : US
Telephone Number : 614-252-8834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2015
Last Update Date : 11/17/2017

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Directions to “ CANDACE S BOHANAN LPC” Practice Location

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