Provider Demographics
NPI:1023110848
Name:BOEHNE, CURTIS WILLIAM (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:WILLIAM
Last Name:BOEHNE
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2401 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1188
Mailing Address - Country:US
Mailing Address - Phone:618-993-4117
Mailing Address - Fax:618-998-5668
Practice Address - Street 1:1 DOCTORS PARK RD
Practice Address - Street 2:SUITE G
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6251
Practice Address - Country:US
Practice Address - Phone:618-246-2910
Practice Address - Fax:618-246-2912
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical