Individual
MIRIAM BODDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CASAC-T
Contact information
Practice address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170
Mailing address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
41014
NY
Other
Enumeration date
10/18/2025
Last updated
10/21/2025
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