Mindy Beth Bodzin, MA,CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

011663-1 Issued in NY

Practice address

116 Westend Ave
Unit 39
Freeport, NY 11520-5251

Phone

(516) 378-5297

Fax

(516) 378-5297

NPI assigned

Mar 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700917465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 WESTEND AVE",
            "address_2": "UNIT 39",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115205251",
            "telephone_number": "516-378-5297",
            "fax_number": "516-378-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 WESTEND AVE",
            "address_2": "UNIT 39",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115205251",
            "telephone_number": "516-378-5297",
            "fax_number": "516-378-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODZIN",
        "first_name": "MINDY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "MA,CCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "011663-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Freeport, NY
• Providers in Freeport, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.