Bodhi Leaf, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

57473 Issued in TX

Legal business name

BODHI LEAF, PLLC

Practice address

1300 West Lynn Drive
Suite 207
Austin, TX 78703

Phone

(512) 653-4623

NPI assigned

Feb 3, 2016

Organization subpart

No

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

Authorized official

Name

Sashi Gabrielle Kimball, LCSW

Title

Sole Member

Phone

(512) 653-4623

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1053779207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 34TH ST",
            "address_2": "APT B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051665",
            "telephone_number": "512-653-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 WEST LYNN DRIVE",
            "address_2": "SUITE 207",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78703",
            "telephone_number": "512-653-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODHI LEAF, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "SASHI",
        "authorized_official_middle_name": "GABRIELLE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "512-653-4623",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sreevidya Bodapati, D.D.S., M.S.
• Drew Marie Bodden
• Nicolas Rodriguez Bodden
• Sara Bode, FNP-C
• Weeranun Dechyapirom Bode, M.D.
• Jakoyah Alexis Bodie
• Alexa Bodman, MD
• Erika Melissa Bodoin
• Kelly Johanna Bodu, LMFT
• Body Evolution Acupuncture and Wellness, PLLC

• Clinical Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.