Amy Elizabeth Bodine, LSW

Individual provider Active NPI Clinical Social Worker · Matawan, NJ

NPI 1902397979 · NPPES record last updated May 24, 2018

Key facts

NPI
1902397979
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
44SL06320200 (NJ)
Practice address
166 Main St
Matawan, NJ 07747-3104
Phone
(732) 290-9040
NPI assigned
May 24, 2018
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
44SL06320200NJMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SL06320200 NJ Yes

Addresses

Primary practice location

166 Main St
Matawan, NJ 07747-3104

Mailing address

166 Main St
Matawan, NJ 07747-3104

Other names

  • Miss Amy Elizabeth Mackenzie Former name

Other providers in Matawan, NJ

All providers in Matawan, NJ · Clinical Social Worker in New Jersey

Sources for this page

Verify at the official NPI Registry.