Bodhi Psychotherapy and Consulting, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BODHI PSYCHOTHERAPY AND CONSULTING, LLC

Practice address

518 S Main St Ofc 6
Simpsonville, SC 29681-3220

Phone

(443) 670-7977

Fax

(410) 882-1079

NPI assigned

Feb 7, 2019

Last updated

Feb 28, 2019By 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

Marilyn Renee Goldman, LCSW-C, LISW-CPNPI 1285650762

Title

Managing Member

Phone

(410) 602-2545

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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.

• Marilyn Renee' Goldman, LCSW-C, LISW-CP

  • Clinical Social Worker
  • Simpsonville, SC
  • NPI 1285650762
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1578028106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10960",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212340960",
            "telephone_number": "410-882-7967",
            "fax_number": "410-882-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 S MAIN ST OFC 6",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813220",
            "telephone_number": "443-670-7977",
            "fax_number": "410-882-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODHI PSYCHOTHERAPY AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "410-602-2545",
        "authorized_official_credential": "LCSW-C, LISW-CP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Blanton
• Benjamin Allen Blanton, DPT
• Melody Garner Blighton, MSW, LISW-CP
• David Blondeau
• Terry J. Blum Haas, MSW, LISW-CP
• Cynthia Bodway, PTA
• Regina Ann Boger
• Bon Secours Medical Group Greenville Specialty Care LLC (Bon Secours Piedmont Orthopaedics)
• Anthony Bondanza
• Anthony Bonofiglio, PHARM.D.

• Clinical Social Worker in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.