Basic Information
Provider Information
NPI: 1932271350
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOHL
FirstName: JOHN
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: LISAC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2017 N 7TH ST
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850062102
CountryCode: US
TelephoneNumber: 6024524684
FaxNumber: 6023580399
Practice Location
Address1: 3306 W CATALINA DR
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850175291
CountryCode: US
TelephoneNumber: 6023530703
FaxNumber: 6023530715
Other Information
ProviderEnumerationDate: 11/14/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XLISAC1634AZY Behavioral Health & Social Service ProvidersCounselorMental Health

ID Information
IDTypeStateIssuerDescription
LISAC163401AZTHERAPISTOTHER


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