# BODHI PSYCHOTHERAPY AND CONSULTING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578028106
- **Authorized official:** MARILYN RENEE GOLDMAN LCSW-C, LISW-CP (MANAGING MEMBER)
- **Authorized official phone:** (410) 602-2545

## Contact information

- **Practice address:** 518 S MAIN ST OFC 6, SIMPSONVILLE, SC 29681-3220
- **Practice address phone:** (443) 670-7977
- **Practice address fax:** (410) 882-1079
- **Mailing address:** PO BOX 10960, BALTIMORE, MD 21234-0960
- **Mailing address phone:** (410) 882-7967
- **Mailing address fax:** (410) 882-1079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 02/07/2019
- **Last updated:** 02/28/2019