Jeannine Bodner, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009794 Issued in NC

Legal business name

JEANNINE BODNER, LCSW, PLLC

Practice address

120-D South Village Lane
Davidson, NC 28036-8877

Phone

(704) 995-7686

Fax

(704) 659-4010

NPI assigned

Mar 19, 2016

Organization subpart

No

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

Authorized official

Name

Jeannine Bodner, LCSWNPI 1932443181

Title

Owner

Phone

(704) 995-7686

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeannine Bodner, LCSW

  • Clinical Social Worker
  • Davidson, NC
  • NPI 1932443181
  Medicare reassignment Care Compare group NPD Authorized official
• Kaylee A Bodner, LCSW-A, LCAS-A

  • Clinical Social Worker
  • Davidson, NC
  • NPI 1699490938
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1458345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1255792156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120-D SOUTH VILLAGE LANE",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368877",
            "telephone_number": "704-995-7686",
            "fax_number": "704-659-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120-D SOUTH VILLAGE LANE",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368877",
            "telephone_number": "704-995-7686",
            "fax_number": "704-659-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNINE BODNER, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-19",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "BODNER",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-995-7686",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inspire Chiropractic & Wellness
• Julie Megan Izykowski, SLP
• Brandi Rochelle Jackson, DDS
• Candace Rowe Jackson, PTA
• Aime A. Janawsky
• Emily Setliff Johnson, PA
• Haley Catherine Johnson, PA-C
• Renee Shull Johnson, MA, NCC, LPC
• Jennifer Johnston, MA, LCMHC-A, NCC
• Melissa Jones, COTA/L

• Clinical Social Worker in Davidson, NC
• Providers in Davidson, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.