Robert J Bodzioch, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC005975 Issued in GA

Practice address

8303 Office Park Drive
B
Douglasville, GA 30134

Phone

(678) 838-8333

NPI assigned

Oct 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Vision Counseling Center, LLC

  • Professional Counselor
  • Douglasville, GA
  • NPI 1578704250
  NPD (past)

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1649580549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8303 B OFFICE PARK DRIVE",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30134",
            "telephone_number": "678-838-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 OFFICE PARK DRIVE",
            "address_2": "B",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "30134",
            "telephone_number": "678-838-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODZIOCH",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC005975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.