William Leon Boddie II, L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW # 21294 Issued in CA

Practice address

1524 McHenry Ave
Suite # 450
Modesto, CA 95350-4500

Phone

(209) 557-6217

Fax

(209) 557-9032

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003842311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "SUITE # 450",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-557-6217",
            "fax_number": "209-557-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "SUITE # 450",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-557-6217",
            "fax_number": "209-557-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODDIE",
        "first_name": "WILLIAM",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LSW # 21294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "05000PWI LCS21294016",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "193184",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Boas
• Carla Marie Boatner, MFTI
• Alicia Bobo
• Francine Bockmon-Ortiz, APCC
• Roxanne C Boddie, SUPERVISOR
• Ashleigh E Bodell, PA-C
• Precious Body, MPSS
• Geraldine D Boek
• Justus Boek
• Nicole Kathleen Boere

• Clinical Social Worker in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.