Bodhi Tree Therapeutic Services

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BODHI TREE THERAPEUTIC SERVICES

Practice address

5512 Fairfax St
Orlando, FL 32812-7732

Phone

(202) 374-0573

NPI assigned

Jul 26, 2022

Organization subpart

No

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

Authorized official

Name

Shakira Vasquez Moscoso, LMHC

Title

Owner

Phone

(202) 374-0573

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shakira Vasquez, LMHC

  • Mental Health Counselor
  • Orlando, FL
  • NPI 1669988606
  NPD

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1134855869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 FAIRFAX ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328127732",
            "telephone_number": "202-374-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 FAIRFAX ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328127732",
            "telephone_number": "202-374-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODHI TREE THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "VASQUEZ MOSCOSO",
        "authorized_official_first_name": "SHAKIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-374-0573",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MH17846",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shakira@bodhitreetherapy.org",
            "affiliation": "N",
            "address_1": "5512 Fairfax St",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328127732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Tulloss Bockian, ARNP-BC
• Melissa Bode, MA
• Raymond M Bodee, D.C
• Erin Bodenheimer, PHARMD
• Frank Bodenmiller, LMHC
• Richmond Bodie
• Bodies in Motion Post Op Services
• Brittany Bodnick
• Danielle Marie Bodovetz, OTR/L
• Jovan Jordan Bodrato

• Adult Mental Health Clinic/Center in Orlando, FL
• Providers in Orlando, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.