| Bodhi Psychotherapy And Consulting, Llc | |
|
518 S Main St Ofc 6 Simpsonville SC 29681-3220 | |
| (443) 670-7977 | |
| (410) 882-1079 |
| Full Name | Bodhi Psychotherapy And Consulting, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 518 S Main St Ofc 6, Simpsonville, South Carolina |
| Authorized Official Name and Position | Marilyn Renee Goldman (MANAGING MEMBER) |
| Authorized Official Contact | 4106022545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bodhi Psychotherapy And Consulting, Llc Po Box 10960 Baltimore MD 21234-0960 Ph: (410) 882-7967 | Bodhi Psychotherapy And Consulting, Llc 518 S Main St Ofc 6 Simpsonville SC 29681-3220 Ph: (443) 670-7977 |
| NPI Number | 1578028106 |
|---|---|
| Provider Enumeration Date | 02/07/2019 |
| Last Update Date | 02/28/2019 |
| Medicare PECOS PAC ID | 1658604061 |
|---|---|
| Medicare Enrollment ID | O20190617002246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578028106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marilyn Renee' Goldman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285650762 PECOS PAC ID: 7315953338 Enrollment ID: I20190617002348 |
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