Provider Demographics
NPI:1578340733
Name:BOHN, HAYLEY (LMSW, LICSW)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:BOHN
Suffix:
Gender:X
Credentials:LMSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 DEXTER PINCKNEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-8928
Mailing Address - Country:US
Mailing Address - Phone:734-327-6427
Mailing Address - Fax:
Practice Address - Street 1:10200 DEXTER PINCKNEY RD STE 100
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-8928
Practice Address - Country:US
Practice Address - Phone:734-327-6427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2024-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1273711041C0700X
MI68011174831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical