Provider Demographics
NPI:1700523149
Name:BODIE, MARLEA ELIZABETH (LISW-CP)
Entity Type:Individual
Prefix:
First Name:MARLEA
Middle Name:ELIZABETH
Last Name:BODIE
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GRANGER DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-3623
Mailing Address - Country:US
Mailing Address - Phone:803-645-6088
Mailing Address - Fax:
Practice Address - Street 1:655 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6415
Practice Address - Country:US
Practice Address - Phone:803-641-5933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical