Provider Demographics
NPI:1720611064
Name:CENTER FOR PSYCHOLOGY AND FAITH INC
Entity Type:Organization
Organization Name:CENTER FOR PSYCHOLOGY AND FAITH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BODIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-947-4222
Mailing Address - Street 1:35 UNITED DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1056
Mailing Address - Country:US
Mailing Address - Phone:508-238-8646
Mailing Address - Fax:
Practice Address - Street 1:71 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-1677
Practice Address - Country:US
Practice Address - Phone:508-947-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty