NPI 1548369390 · live from the CMS NPI Registry
Mark A Bodwalk, LPC LMFT
Marriage & Family Therapist in Clifton, VA. National Provider Identifier 1548369390, active.
NPI record
| NPI | 1548369390 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 6922 Newman Rd, Clifton, VA 20112 |
| Practice phone | 703-830-8864 |
| Mailing address | 6922 Newman Rd, Clifton, VA 20124 |
| Enumerated | September 21, 2006 |
| Last updated | September 11, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | 0701002569 (VA) |
| Marriage & Family Therapist primary | 106H00000X | 0717000297 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.