Individual
AMBER DAWN BODAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LSW, MSW,
Contact information
Practice address
800 MACARTHUR BLVD STE 5, MUNSTER, IN 46321-2917
(219) 392-7025
(219) 392-7026
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
33005883A
IN
1041C0700X
Clinical Social Worker
Primary
34007390A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300069498
—
IN
Enumeration date
06/07/2016
Last updated
01/19/2023
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