Provider Demographics
NPI:1740747237
Name:BODEY, STEVEN K (LISW-S)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:K
Last Name:BODEY
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10130 WHITEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1656
Mailing Address - Country:US
Mailing Address - Phone:216-496-9917
Mailing Address - Fax:
Practice Address - Street 1:10130 WHITEWOOD RD
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1656
Practice Address - Country:US
Practice Address - Phone:216-496-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0009333-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical