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BODHI LEAF PLLC NPI 1053779207


NPI Information

NPI: 1053779207
Provider Name: BODHI LEAF, PLLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
1300 WEST LYNN DRIVE
SUITE 207
AUSTIN, TX
ZIP 78703
Phone: (512) 653-4623
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BODHI LEAF, PLLC is a clinical social worker in Austin, TX. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. BODHI LEAF, PLLC NPI is 1053779207. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1300 WEST LYNN DRIVE
SUITE 207
AUSTIN, TX
ZIP 78703
Phone: (512) 653-4623

The provider's authorized official is Sashi Gabrielle Kimball .
The authorized official title is Sole Member and has the following contact phone number (512) 653-4623.

The enumeration date for this NPI number is 2/3/2016 and was last updated on 2/3/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical57473TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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