Provider Demographics
NPI:1699880120
Name:BODIO, WILLIAM P (LMHC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:P
Last Name:BODIO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-1677
Mailing Address - Country:US
Mailing Address - Phone:508-947-4222
Mailing Address - Fax:
Practice Address - Street 1:71 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-1677
Practice Address - Country:US
Practice Address - Phone:508-947-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health