Janessa Elise Bodzon, LCSW

Individual provider Active NPI Clinical Social Worker · Bristol, CT

NPI 1891067641 · NPPES record last updated Feb 8, 2012

Key facts

NPI
1891067641
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
007824 (CT)
Practice address
225 N Main St Ste 106
Bristol, CT 06010-4993
Phone
(860) 585-4300
NPI assigned
Feb 8, 2012
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)
No

State licenses

LicenseStateTypeSpecialty
007824CTMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 007824 CT Yes

Addresses

Primary practice location

225 N Main St Ste 106
Bristol, CT 06010-4993

Mailing address

12 French St
Seymour, CT 06483-3021
Phone (203) 494-1720

Other providers in Bristol, CT

All providers in Bristol, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.