MR. MARK A BODWALK


Address: 6922 Newman Rd, Clifton, VA 20112-1613
Phone: 7038308864

MR. MARK A BODWALK (NPI# 1548369390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548369390
Entity Type Individual
Full Name MR. MARK A BODWALK
Credential LPC LMFT
Practice Address 6922 Newman Rd
Clifton
VA 20112-1613
Mailing Address 6922 Newman Rd
Clifton
VA 20124-1613
Practice Telephone 7038308864
Practice Fax Number 7038308864
Mailing Telephone 7038308864
Mailing Fax Number 7038308864
Enumeration Date 2006-09-21
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 101YP2500X Counselor
Specialization: Professional
0701002569 VA Behavioral Health & Social Service Providers
X 106H00000X Marriage & Family Therapist 0717000297 VA Behavioral Health & Social Service Providers

Office Location

Street Address 6922 NEWMAN RD
City CLIFTON
State VA
Zip Code 20112-1613

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1548627797 Dawnita Truitt-calderone Speech-Language Pathologist 14715 Bristow Rd, Manassas, VA 20112 2016-01-19
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1205106069 Andre Delray Route Home Health Aide 7600 Georgia Ave, Premier Health Services, Suite 323, Washington, DC 20112 2012-01-10
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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1932697612 Zachary Pitoniak Counselor 1010 Clifton Ave Ste 201, Clifton, NJ 07013-3528 2018-04-27
1922512185 Jameline Jacqueline Lofing Counselor 628 Livvy Ct, Clifton, CO 81520-7444 2017-11-27
1790189603 Terrell Proctor Counselor 291 River Road, Clifton, NJ 07014 2014-10-21
1407262207 Matthew Lichten Counselor 777 Passaic Ave Ste 365, Clifton, NJ 07012-1804 2014-07-01
1245520931 Gianna Marie Caruso Counselor 46 Macarthur Dr, Clifton, NJ 07013-3926 2011-04-14
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Competitor

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City CLIFTON
Zip Code 20112

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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