Provider Demographics
NPI:1538465752
Name:BODNAR COUNSELING, INC.
Entity Type:Organization
Organization Name:BODNAR COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BODNAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW & LMFT
Authorized Official - Phone:574-277-2525
Mailing Address - Street 1:17903 STATE ROAD 23
Mailing Address - Street 2:SUITE #3
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1642
Mailing Address - Country:US
Mailing Address - Phone:574-277-2525
Mailing Address - Fax:574-243-7735
Practice Address - Street 1:17903 STATE ROAD 23
Practice Address - Street 2:SUITE #3
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1642
Practice Address - Country:US
Practice Address - Phone:574-277-2525
Practice Address - Fax:574-243-7735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-05
Last Update Date:2011-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001331A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty