Praveen Bodakunta, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95023203 Issued in CA

Practice address

300 Lenora St Ste 401
Seattle, WA 98121-2411

Phone

(206) 699-8261

NPI assigned

Jan 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Alliance for South Sound Health

  • Psychiatric Hospital
  • Tacoma, WA
  • NPI 1891298980
  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Telecare Mental Health Services of Washington, Inc

  • Psychiatric Residential Treatment Facility
  • Tacoma, WA
  • NPI 1780913657
  Medicare reassignment NPD
• Psychiatric Connections LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • E Fife, WA
  • NPI 1649076050
  NPD Authorized official
• Multicare Health System

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1396297487
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Telecare Mental Health Services of Washington Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1902540362
  NPD
• Telecare Mental Health Services of Washington, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vancouver, WA
  • NPI 1699162925
  NPD
• Telecare Mental Health Services of Washington, Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Federal Way, WA
  • NPI 1790298347
  NPD (past)

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1295243848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LENORA ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212411",
            "telephone_number": "206-699-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LENORA ST STE 401",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212411",
            "telephone_number": "206-699-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODAKUNTA",
        "first_name": "PRAVEEN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-17",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95023203",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "288853",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11038890",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "862811",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60909328",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0103995-C-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matilda Bockarie, NP-PMHNP
• Carlie Jae Bockelman, LMP
• Christina E Bockman, PHARM.D.
• Rebecca Marjorie Bockow, DDS
• Lee Bockus
• Rachel Leavitt Bodansky, RN, ARNP
• Anneliese Bodding-Long, PHARMD
• Amy Bode, MD
• Eric Bodelson, RN
• Karina Bodemeijer, RD

• Psychiatric/Mental Health Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.