Jamie L Bodenhafer LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087081 Issued in MI

Legal business name

JAMIE L BODENHAFER LLC

Practice address

17657 Avilla Blvd
Lathrup Village, MI 48076-2732

Phone

(248) 259-3527

NPI assigned

Dec 21, 2010

Last updated

Dec 21, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jamie Lorraine Bodenhafer, L.M.S.W.NPI 1508909532

Title

Clincal Social Worker/Administrator

Phone

(248) 259-3527

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jamie Lorraine Bodenhafer, L.M.S.W.

  • Clinical Social Worker
  • Lathrup Village, MI
  • NPI 1508909532
  Medicare reassignment NPD Authorized official
• Erica Janelle Thompson, LLMSW

  • Social Worker
  • Warren, MI
  • NPI 1346561214
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1104129782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17657 AVILLA BLVD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762732",
            "telephone_number": "248-259-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17657 AVILLA BLVD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762732",
            "telephone_number": "248-259-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMIE L BODENHAFER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-21",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "BODENHAFER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "CLINCAL SOCIAL WORKER/ADMINISTRATOR",
        "authorized_official_telephone_number": "248-259-3527",
        "authorized_official_credential": "L.M.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.