NPIMap

Organization Active NPI

Bodenheimer Psychological & Counseling Center LLC

  • Clinical Psychologist
  • Anniston, AL
National Provider Identifier
1972575272
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
978 Issued in AL
Legal business name
BODENHEIMER PSYCHOLOGICAL & COUNSELING CENTER LLC
Practice address
1523 Leighton Ave
Anniston, AL 36207-3828
Phone
(256) 236-0070
Fax
(256) 237-0079
NPI assigned
Feb 2, 2006
Last updated
Aug 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lucile Bodenheimer, PSYDNPI 1144405531
Title
Licensed Clinical Psycholgist Owner
Phone
(256) 236-0070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 978 AL Primary

Addresses

Primary practice location

1523 Leighton Ave
Anniston, AL 36207-3828

Mailing address

PO Box 952
Anniston, AL 36202-0952
Phone (256) 236-0070

Other names 1

  • Lucile Bodenheimer Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000590 AL Part B Supplier - Clinic/Group Practice 3971498932 Receives reassigned benefits from 1 practitioner
Practice locations: Anniston, AL

National Provider Directory

National Provider Directory

Locations

1523 Leighton Ave
Anniston, AL 36207
Phone (256) 236-0070

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1972575272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 952",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362020952",
            "telephone_number": "256-236-0070",
            "fax_number": "256-237-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 LEIGHTON AVE",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362073828",
            "telephone_number": "256-236-0070",
            "fax_number": "256-237-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODENHEIMER PSYCHOLOGICAL & COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "BODENHEIMER",
        "authorized_official_first_name": "LUCILE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLGIST OWNER",
        "authorized_official_telephone_number": "256-236-0070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucile Bodenheimer",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Anniston, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.