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HEATHER JORDAN BODDIE-RUSSO LCSW NPI 1588090286


NPI Information

NPI: 1588090286
Provider Name: HEATHER JORDAN BODDIE-RUSSO, LCSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

PECOS Registration: Yes

Address:
2101 ALEXIAN DR
SUITE D
SAN JOSE, CA
ZIP 95116
Phone: (408) 272-6513
Get Directions

Heather Jordan Boddie-russo, LCSW is a clinical social worker in San Jose, CA. 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. Heather Jordan Boddie-russo, LCSW NPI is 1588090286. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2101 ALEXIAN DR
SUITE D
SAN JOSE, CA
ZIP 95116-901
Phone: (408) 272-6513
Fax: (408) 272-6557

The NPI 1588090286 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 9/25/2013 and was last updated on 7/30/2018.


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 WorkerClinicalLCS 29058CALIFORNIAYes

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: 11/14/2023

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