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HEATHER NICOLE BODIE LCSW
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1477195899
Individual Registrant: HEATHER NICOLE BODIE LCSW
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
49 WHITEHALL AVE MYSTIC, CT 06355-1966 US
Tel: 860-961-5702 Fax: 860-415-9370
Tel: 860-961-5702 Fax: 860-415-9370
Contact information for business:
11 PEVETTY DR EAST HAVEN, CT 06512-4816 US
Tel: 203-927-7364 Fax: --
Tel: 203-927-7364 Fax: --
Registration Information:
NPI: 1477195899
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical | CT | 009787 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
