Michael Bodem, B.A.

Individual provider Active NPI Clinical Social Worker · Acton, MA

NPI 1376971374 · NPPES record last updated Oct 29, 2013

Key facts

NPI
1376971374
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
360 Massachusetts Ave
Suite 201
Acton, MA 01720-3750
Phone
(978) 460-8482
NPI assigned
Oct 29, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

360 Massachusetts Ave
Suite 201
Acton, MA 01720-3750

Mailing address

14 Deerfield Rd
Wellesley, MA 02481-1213
Phone (781) 223-3315

Other providers in Acton, MA

All providers in Acton, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.