Active NPI
Lindsay Bodtke, LMSW, MSW
- Clinical Social Worker
- South Haven, MI
National Provider Identifier
1164067492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801095765
- Practice address
- 1007 Wells St
South Haven, MI 49090-9612 - Phone
- (269) 637-5297
- NPI assigned
- Nov 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801095765 | MI | Primary |
Addresses
Primary practice location
1007 Wells St
South Haven, MI 49090-9612
Mailing address
PO Box 249
Paw Paw, MI 49079-0249
Phone (269) 657-5574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801095765 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577318400000",
"number": "1164067492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 249",
"city": "PAW PAW",
"state": "MI",
"postal_code": "490790249",
"telephone_number": "269-657-5574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 WELLS ST",
"city": "SOUTH HAVEN",
"state": "MI",
"postal_code": "490909612",
"telephone_number": "269-637-5297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODTKE",
"first_name": "LINDSAY",
"credential": "LMSW, MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-11",
"last_updated": "2019-12-26",
"certification_date": "2019-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801095765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.