Individual
MS. DEENA S. BODINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
60 S STOCKWELL RD, EVANSVILLE, IN 47714-0247
(812) 476-5437
(812) 422-7558
Mailing address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005487A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000752280
ANTHEM
IN
05
—
100240880
—
IN
01
—
12138474
CAQH
IN
Enumeration date
04/07/2010
Last updated
10/29/2014
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