Provider Demographics
NPI:1699451377
Name:RELEASE THERAPY, PLLC
Entity type:Organization
Organization Name:RELEASE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHRER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-757-5970
Mailing Address - Street 1:900 SKOKIE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4014
Mailing Address - Country:US
Mailing Address - Phone:312-600-7832
Mailing Address - Fax:
Practice Address - Street 1:900 SKOKIE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4014
Practice Address - Country:US
Practice Address - Phone:312-600-7832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty