Lisa Marie Bodnar, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.017097 Issued in IL

Practice address

572 Crescent Blvd
Glen Ellyn, IL 60137-4151

Phone

(844) 984-7252

NPI assigned

Mar 7, 2022

Last updated

Mar 7, 2022By the provider in NPPES

Sex

Female

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

State licenses

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1760139968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S YALE AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812872",
            "telephone_number": "312-310-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 CRESCENT BLVD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374151",
            "telephone_number": "844-984-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.017097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claire Biga, MS, RDN, LDN, CLC
• Biopulse Laboratory LLC
• Ashley Margaret Biro
• BKD Personal Assistance Services LLC (Best at Home Care Glen Ellyn)
• Board of Education District 41
• Lisa Anne Bong, LCSW
• Stephanie Lynn Booton, ATC/L
• John Steven Borello, D.D.S.
• Katherine Marie Borello, D.D.S
• Brian Peter Borger

• Mental Health Counselor in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.