Deshika Venezio Bodhi Jackson, MSW, LSWAIC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

60997028 Issued in WA

Practice address

611 12TH Ave S
Seattle, WA 98144-2007

Phone

(206) 324-9360

NPI assigned

Oct 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Deshikia Venezio Bodhi-Jackson Other name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seattle Indian Health Board

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1316012461
  Medicare reassignment

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1164065108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 12TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442007",
            "telephone_number": "206-324-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 12TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442007",
            "telephone_number": "206-324-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODHI JACKSON",
        "first_name": "DESHIKA",
        "middle_name": "VENEZIO",
        "credential": "MSW, LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "60997028",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SWI.LW.61395765",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CDPT.CO.70090832",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH LSWAIC CREDENTIAL",
            "identifier": "60997028",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESHIKIA",
            "last_name": "BODHI-JACKSON",
            "middle_name": "VENEZIO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amy Bode, MD
• Eric Bodelson, RN
• Karina Bodemeijer, RD
• Elisa K Boden, M.D.
• Nozer Bodhanwala
• Bodhi Tree LLC
• William J. Bodick, LICSW, RC
• Karli Bodine
• Body Conscious, P.S.
• Body in Balance Acupuncture PLLC

• Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.