Wendyleigh Kathleen Bodick, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · Cornelius, NC

NPI 1699727735 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1699727735
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C003703 (NC)
Practice address
21300 Catawba Ave
Cornelius, NC 28031-8505
Phone
(704) 892-2254
Fax
(704) 892-0366
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
C003703NCMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C003703 NC Yes

Addresses

Primary practice location

21300 Catawba Ave
Cornelius, NC 28031-8505

Mailing address

113 Davidson Ridge LN
Mooresville, NC 28115-7800
Phone (704) 892-2254

Other identifiers

IdentifierTypeStateIssuer
6002858MedicaidNC

Other providers in Cornelius, NC

All providers in Cornelius, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.