Provider Demographics
NPI:1801500384
Name:BODNAR, SIERRA (LPC)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:BODNAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 TAUNTON WAY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1465
Mailing Address - Country:US
Mailing Address - Phone:940-535-4166
Mailing Address - Fax:
Practice Address - Street 1:3316 TAUNTON WAY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1465
Practice Address - Country:US
Practice Address - Phone:940-535-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83293101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health